MEDICARE: DR. KATHLEEN CONNOLLY CRANDALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171000000X	Military Health Care Provider

General Provider Information

NPI Number	:	1518751361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN CONNOLLY CRANDALL MD

Provider Business Mailing Address
First Line	:	8901 ROCKVILLE PIKE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8901 ROCKVILLE PIKE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-0001
Country	:	US
Telephone Number	:	301-295-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	12/20/2025

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