Provider Demographics
NPI:1841281011
Name:CRAWFORD-GREEN, CYNTHIA (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CRAWFORD-GREEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6196 OXON HILL RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3100
Mailing Address - Country:US
Mailing Address - Phone:301-567-5888
Mailing Address - Fax:301-567-8040
Practice Address - Street 1:6196 OXON HILL RD
Practice Address - Street 2:SUITE 500
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3100
Practice Address - Country:US
Practice Address - Phone:301-567-5888
Practice Address - Fax:301-567-8040
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027650207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD428003Medicare ID - Type Unspecified
MDB94877Medicare UPIN