Organization
MERRITT RADIOLOGICAL MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT J CROUTCH MD (PRESIDENT)
(209) 577-9900
Entity
Organization
Contact information
Practice address
526 CHARITY WAY, MODESTO, CA 95356
(209) 577-9900
(209) 577-1509
Mailing address
PO BOX 906, SALIDA, CA 95368
(209) 577-9900
(209) 577-1509
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G606980
—
CA
Enumeration date
02/27/2007
Last updated
08/22/2020
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