Provider Demographics
NPI:1134127798
Name:CRAWFORD, MICHAELE A (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAELE
Middle Name:A
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 POINT PLZ
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2540
Mailing Address - Country:US
Mailing Address - Phone:724-282-0900
Mailing Address - Fax:724-284-1233
Practice Address - Street 1:164 POINT PLZ
Practice Address - Street 2:SUITE 203
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2540
Practice Address - Country:US
Practice Address - Phone:724-282-0900
Practice Address - Fax:724-284-1233
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004652R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7745378OtherAETNA
PA001822285Medicaid
917840OtherBLUE SHIELD
PA001822285Medicaid
PA04317556AMedicare PIN
917840OtherBLUE SHIELD