Provider Demographics
NPI:1558569509
Name:CRYER, CHAD MICHAEL TOWNSEND (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MICHAEL TOWNSEND
Last Name:CRYER
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 1:932 WANAAO RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3565
Mailing Address - Country:US
Mailing Address - Phone:240-418-6624
Mailing Address - Fax:
Practice Address - Street 1:932 WANAAO RD
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3565
Practice Address - Country:US
Practice Address - Phone:240-418-6624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17901208600000X
UT9399487-1205208600000X
VA0101241525208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101241525OtherMEDICAL LICENCE NUMBER
HI17901OtherMEDICAL LICENCE NUMBER
UT9399487-1205OtherMEDICAL LICENCE NUMBER