Provider Demographics
NPI:1780720730
Name:TOWLE-KREWSON, CYNTHIA R (PA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:R
Last Name:TOWLE-KREWSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 MEDICAL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3076
Mailing Address - Country:US
Mailing Address - Phone:410-573-1110
Mailing Address - Fax:410-266-0714
Practice Address - Street 1:2003 MEDICAL PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3076
Practice Address - Country:US
Practice Address - Phone:410-573-1110
Practice Address - Fax:410-266-0714
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC0001020OtherPHYSICIAN ASST LICENSE