Provider Demographics
NPI:1578136370
Name:CREWS, ROBERT CLINTON (MPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CLINTON
Last Name:CREWS
Suffix:
Gender:M
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 BULRUSH CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9269
Mailing Address - Country:US
Mailing Address - Phone:757-287-7733
Mailing Address - Fax:757-436-1378
Practice Address - Street 1:713 BULRUSH CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-9269
Practice Address - Country:US
Practice Address - Phone:757-287-7733
Practice Address - Fax:757-436-1378
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA17493Medicaid