Provider Demographics
NPI:1588537385
Name:CROWDER, IRVING LEIGH SR
Entity type:Individual
Prefix:MR
First Name:IRVING
Middle Name:LEIGH
Last Name:CROWDER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 DUPONT ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-3520
Mailing Address - Country:US
Mailing Address - Phone:810-936-1903
Mailing Address - Fax:
Practice Address - Street 1:3609 DUPONT ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-3520
Practice Address - Country:US
Practice Address - Phone:810-936-1903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider