MEDICARE: SAMUEL CROFF JR. 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	207Q00000X	Family Medicine Physician	D0058177	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962411561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL CROFF JR. MD

Provider Business Mailing Address
First Line	:	7450 ALBERT RD FL 3
Second Line	:
City	:	BRANDYWINE
State	:	MD
Zip	:	20613-3035
Country	:	US
Telephone Number	:	301-888-2233
Fax Number	:

Provider Business Practice Location Address
First Line	:	1458 ADDISON RD S
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-4413
Country	:	US
Telephone Number	:	301-324-1500
Fax Number	:	301-324-6405

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	02/16/2023

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Directions to “ SAMUEL CROFF JR. MD” Practice Location

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