Individual
DR. HEATHER ANN CRONOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
15855 19 MILE RD, EMERGENCY MEDICINE DEPARTMENT, CLINTON TWP, MI 48038-3504
(586) 263-2601
(586) 263-2589
Mailing address
38925 ANN ARBOR ROAD, CREDENTIALING/PAYER CONTRACTING SERVICES, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101017322
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12262174
CAQH
—
05
—
1891959458
—
MI
Enumeration date
07/14/2008
Last updated
10/10/2022
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