Individual
DR. MICAH SHAWN CROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1940 TAYLOR DR APT 6, WINCHESTER, VA 22601-6338
(440) 263-4190
Mailing address
1940 TAYLOR DR APT 6, WINCHESTER, VA 22601-6338
(440) 263-4190
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35 093481
OH
207Q00000X
Family Medicine Physician
Primary
0116018898
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2956449
—
OH
Enumeration date
07/06/2007
Last updated
04/26/2010
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