Healthcare Provider Details

I. General information

NPI: 1972291615
Provider Name (Legal Business Name): KEVIN TAFT CROWLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 05/22/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE BLDG 19
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

III MARINE EXPEDITIONARY FORCE SURGEON UNIT 35605
FPO AP
96382
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-2466
  • Fax:
Mailing address:
  • Phone: 508-280-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number282N00000X
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number1720292501
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101283948
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: