Provider Demographics
NPI:1871783316
Name:THEODORE H. CRYER, M.D., F.A.C.S.
Entity type:Organization
Organization Name:THEODORE H. CRYER, M.D., F.A.C.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CRYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-762-1158
Mailing Address - Street 1:1647 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1874
Mailing Address - Country:US
Mailing Address - Phone:717-762-1158
Mailing Address - Fax:717-762-8858
Practice Address - Street 1:1647 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-1874
Practice Address - Country:US
Practice Address - Phone:717-762-1158
Practice Address - Fax:717-762-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019080E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2144599OtherAETNA
PA3107791OtherMAMSI
PA32521OtherHEALTH AMERICA
PA18278OtherSPECTERA
PA322133OtherPHCS
PA392543OtherNATIONAL VISION ADMINISTR
PA50003090OtherCAPITAL BLUE CROSS
PA0015563110002Medicaid
PA1334892OtherFIRST HEALTH
PA67059OtherPENNSYLVANIA BLUE SHIELD
PA18278OtherSPECTERA
PA50003090OtherCAPITAL BLUE CROSS
PA32521OtherHEALTH AMERICA