Healthcare Provider Details

I. General information

NPI: 1447278320
Provider Name (Legal Business Name): DANIEL J CRABLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CORPORATE DR
GRANTSVILLE MD
21536-1259
US

IV. Provider business mailing address

PO BOX 594
OAKLAND MD
21550-4594
US

V. Phone/Fax

Practice location:
  • Phone: 301-895-8750
  • Fax: 301-895-8751
Mailing address:
  • Phone: 301-895-8750
  • Fax: 301-895-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number053381L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0082522
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: