Provider Demographics
NPI:1770569857
Name:CROWLEY, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:M
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:AIKEN COUNTY PUBLIC HEALTH DEPT
Mailing Address - Street 2:222 BEAUFORT ST NE
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801
Mailing Address - Country:US
Mailing Address - Phone:803-642-1687
Mailing Address - Fax:
Practice Address - Street 1:AIKEN COUNTY PUBLIC HEALTH DEPARTMENT
Practice Address - Street 2:222 BEAUFORT ST NE
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801
Practice Address - Country:US
Practice Address - Phone:803-642-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC859992083P0901X
NV6782207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019451Medicaid
NVF57928Medicare UPIN
NV002019451Medicaid