Individual
FRED MICHAEL CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
524 SE OSCEOLA ST, SUITE 100, STUART, FL 34994-2322
(772) 419-2379
(772) 419-2377
Mailing address
PO BOX 3130, OCALA, FL 34478-3130
(352) 867-8311
(352) 867-1053
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME77601
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256527700
—
FL
01
—
44862
BCBS FL
FL
01
—
44862A
BCBS HMO
FL
01
—
44862B
BCBS HMO
FL
Enumeration date
06/23/2006
Last updated
06/28/2012
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