Provider Demographics
NPI:1992805774
Name:CROMER, MINKA PARIE (C-FNP)
Entity type:Individual
Prefix:
First Name:MINKA
Middle Name:PARIE
Last Name:CROMER
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5103
Mailing Address - Country:US
Mailing Address - Phone:410-542-7800
Mailing Address - Fax:443-836-0405
Practice Address - Street 1:3319 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5103
Practice Address - Country:US
Practice Address - Phone:410-542-7800
Practice Address - Fax:443-836-0405
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN155990207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR155990OtherRN LICENSE
MDN61490OtherCDS
MDN61490OtherCDS