Provider Demographics
NPI:1598947897
Name:LYNDA M CRAWFORD M.D. P.A.
Entity Type:Organization
Organization Name:LYNDA M CRAWFORD M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-262-7550
Mailing Address - Street 1:4000 MITCHELLVILLE RD
Mailing Address - Street 2:206
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3104
Mailing Address - Country:US
Mailing Address - Phone:301-262-7550
Mailing Address - Fax:301-262-0874
Practice Address - Street 1:4000 MITCHELLVILLE RD
Practice Address - Street 2:206
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3104
Practice Address - Country:US
Practice Address - Phone:301-262-7550
Practice Address - Fax:301-262-0874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047741174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG22105Medicare UPIN
MDG02287Medicare PIN