Provider Demographics
NPI:1932295508
Name:CRAWFORD, LYNDA MARIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:MARIA
Last Name:CRAWFORD
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 1:4000 MITCHELLVILLE RD
Mailing Address - Street 2:#206
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716
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
Practice Address - Country:US
Practice Address - Phone:301-262-7550
Practice Address - Fax:301-262-0874
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047741174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02287L01Medicare PIN
MDG22105Medicare UPIN