Provider Demographics
NPI:1730134362
Name:CRANE, PETER DUKE (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:DUKE
Last Name:CRANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4605
Mailing Address - Country:US
Mailing Address - Phone:804-288-8204
Mailing Address - Fax:804-282-2131
Practice Address - Street 1:595 N COURTENAY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4852
Practice Address - Country:US
Practice Address - Phone:321-784-8211
Practice Address - Fax:321-394-9425
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231483207LP2900X
FLME156458208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98283OtherFLORIDA BLUE SHIELD
FLU6360ZMedicare ID - Type UnspecifiedFLORIDA MEDICARE
FLP00273630Medicare ID - Type UnspecifiedMEDICARE RAILROAD
FLH78104Medicare UPIN