Provider Demographics
NPI:1144212010
Name:CAMPBELL, CRAWFORD COWLES (MD)
Entity Type:Individual
Prefix:
First Name:CRAWFORD
Middle Name:COWLES
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PELHAM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2826
Mailing Address - Country:US
Mailing Address - Phone:603-898-2244
Mailing Address - Fax:603-898-2227
Practice Address - Street 1:16 PELHAM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2826
Practice Address - Country:US
Practice Address - Phone:603-898-2244
Practice Address - Fax:603-898-2227
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75499207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3166635Medicaid
MAJ14092Medicare ID - Type Unspecified
MAF62137Medicare UPIN