Provider Demographics
NPI:1124383021
Name:CRICHLOW, CANDICE DANIELLE MARILYN (MD)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:DANIELLE MARILYN
Last Name:CRICHLOW
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 1:300 N 7TH ST
Mailing Address - Street 2:DWPT OF INTERNAL MEDICINE
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4439
Mailing Address - Country:US
Mailing Address - Phone:701-323-6000
Mailing Address - Fax:
Practice Address - Street 1:300 N 7TH ST
Practice Address - Street 2:DWPT OF INTERNAL MEDICINE
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4439
Practice Address - Country:US
Practice Address - Phone:701-323-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND13515208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine