Provider Demographics
NPI:1316023625
Name:STOREY-CRAWFORD, DIONNE M (DPM)
Entity Type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:M
Last Name:STOREY-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 1:3540 CRAIN HWY
Mailing Address - Street 2:STE. 351
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1303
Mailing Address - Country:US
Mailing Address - Phone:301-806-3198
Mailing Address - Fax:301-218-5969
Practice Address - Street 1:15016 DAHLIA DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3088
Practice Address - Country:US
Practice Address - Phone:301-806-3198
Practice Address - Fax:301-218-5969
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01337213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
J368OtherBCBS
2700975OtherEVERCARE
MD400265200Medicaid
DC035496100Medicaid
J368OtherBCBS
DC035496100Medicaid
MD400265200Medicaid