Provider Demographics
NPI:1144280397
Name:MARIA CRUMES M.D. P.C.
Entity type:Organization
Organization Name:MARIA CRUMES M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-999-6625
Mailing Address - Street 1:49086 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-6671
Mailing Address - Country:US
Mailing Address - Phone:313-999-6625
Mailing Address - Fax:
Practice Address - Street 1:49086 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-6671
Practice Address - Country:US
Practice Address - Phone:313-999-6625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010470222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2833962Medicaid
MIB49439Medicare UPIN
MIF37184004Medicare ID - Type Unspecified