Provider Demographics
NPI:1861505646
Name:CROOKS, LLEWELYN (MD FACOG)
Entity Type:Individual
Prefix:DR
First Name:LLEWELYN
Middle Name:
Last Name:CROOKS
Suffix:
Gender:M
Credentials:MD FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18801 CELEBRITY LN
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20860-1500
Mailing Address - Country:US
Mailing Address - Phone:301-924-4298
Mailing Address - Fax:
Practice Address - Street 1:18801 CELEBRITY LN
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1500
Practice Address - Country:US
Practice Address - Phone:301-924-4298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDFO3355Medicare UPIN