Provider Demographics
NPI:1922078708
Name:CRANE, ANGELA ROSE-MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROSE-MARIE
Last Name:CRANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 SOUTH RIVER RD.
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6547
Mailing Address - Country:US
Mailing Address - Phone:603-629-1793
Mailing Address - Fax:
Practice Address - Street 1:168 SOUTH RIVER RD.
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6547
Practice Address - Country:US
Practice Address - Phone:603-629-1793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9315207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30007534Medicaid
NH0109894Y0NH01OtherANTHEM
NHRE3433Medicare ID - Type Unspecified
NH30007534Medicaid