Individual
SUSAN T CROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, SUITE 1204A, INDIANAPOLIS, IN 46202-1239
(317) 962-6739
(317) 962-8281
Mailing address
714 N SENATE AVE, STE 100, INDIANAPOLIS, IN 46202-3763
(317) 715-6402
(317) 715-6415
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01063737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000556652
ANTHEM BCBS
IN
05
—
200870840
—
IN
01
—
P00452681
RAILROAD MEDICARE
IN
01
—
P00742700
RAILROAD MEDICARE
IN
Enumeration date
05/31/2007
Last updated
02/04/2021
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