Provider Demographics
NPI:1003506874
Name:CROWDER, ELIZABETH WALTON (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WALTON
Last Name:CROWDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MANNING DRIVE, CB 7070
Mailing Address - Street 2:PHYSICIANS OFFICE BUILDING, RM G190A
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-966-3343
Mailing Address - Fax:
Practice Address - Street 1:170 MANNING DRIVE, CB 7070
Practice Address - Street 2:PHYSICIANS OFFICE BUILDING, RM G190A
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-966-3343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCROW-D4S046390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program