Individual
DR. MARC J. CRUPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 CORDOVA STATION AVE, CORDOVA, TN 38018-6318
(901) 507-4400
(901) 756-5836
Mailing address
P O BOX 4438, CORDOVA, TN 38088-4438
(901) 507-4400
(901) 756-5836
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000015815
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3144579
BCBS OF TN
TN
01
—
4064441
AETNA
TN
Enumeration date
09/27/2006
Last updated
01/10/2008
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