Individual
DAVID A CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6325 DIGITAL WAY, SUITE 480, INDIANAPOLIS, IN 46278-1678
(317) 275-5005
Mailing address
6325 DIGITAL WAY, SUITE 480, INDIANAPOLIS, IN 46278-1678
(317) 275-5005
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01062616A
IN
2085R0202X
Diagnostic Radiology Physician
20805
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000501707
ANTHEM
IN
05
—
1760481816
—
IN
05
—
1812489000
—
WV
Enumeration date
07/20/2005
Last updated
07/09/2007
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