Individual
MICHELLE LYNN CROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
255 ENTERPRISE BLVD STE 101, GREENVILLE, SC 29615-3530
(864) 454-8120
(864) 454-8125
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
82355
SC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
82355
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
823559
—
SC
Enumeration date
04/08/2016
Last updated
08/30/2022
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