Provider Demographics
NPI:1811608649
Name:CRAWMER, JOHN BRIAN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BRIAN
Last Name:CRAWMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8318 MEADOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-5913
Mailing Address - Country:US
Mailing Address - Phone:559-998-9483
Mailing Address - Fax:
Practice Address - Street 1:8318 MEADOW CREEK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-5913
Practice Address - Country:US
Practice Address - Phone:559-998-9483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program