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Individual

MR. ALLEN WAYNE CROWDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004077
VA
363AS0400X
Surgical Physician Assistant
Primary
0110004077
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1356685499
ANTHEM MEDIGAP
VA
01
371194700
BLACK LUNG
VA
01
P01201634
RAILROAD MEDICARE
VA
Enumeration date
11/15/2012
Last updated
07/08/2021
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