Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2721 | WV |
NPI | 1013274315 |
---|---|
Provider Name | Adam Thomas Crawford |
First Address | Charleston, WV 25304-1228 |
Second Address | Charleston, WV 25304-1210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 04/01/2017 |