Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 058455 | GA |
N | 207PP0204X | Pediatric Emergency Physician | 13017 | NV |
N | 207PP0204X | Pediatric Emergency Physician | 4301055324 | MI |
NPI | 1235286030 |
---|---|
Provider Name | Clifford A. Crawford |
First Address | Cumming, GA 30041-7927 |
Second Address | Cumming, GA 30041-7927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/12/2010 |