Provider Demographics
NPI:1134187594
Name:CRANE, JONATHAN STUART (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:STUART
Last Name:CRANE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1099 MEDICAL CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7346
Mailing Address - Country:US
Mailing Address - Phone:910-251-9944
Mailing Address - Fax:910-763-4666
Practice Address - Street 1:1099 MEDICAL CENTER DR STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7346
Practice Address - Country:US
Practice Address - Phone:910-251-9944
Practice Address - Fax:910-763-4666
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC34583207N00000X
NC034583207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1134187594OtherNPI