Provider Demographics
NPI:1962630814
Name:CRABAPPLE MED, INC.
Entity Type:Organization
Organization Name:CRABAPPLE MED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:REEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-410-1444
Mailing Address - Street 1:10929 CRABAPPLE RD
Mailing Address - Street 2:201B
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7657
Mailing Address - Country:US
Mailing Address - Phone:770-410-1444
Mailing Address - Fax:678-827-0520
Practice Address - Street 1:10929 CRABAPPLE RD
Practice Address - Street 2:201B
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-7657
Practice Address - Country:US
Practice Address - Phone:770-410-1444
Practice Address - Fax:678-827-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028633207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty