Healthcare Provider Details

I. General information

NPI: 1154588051
Provider Name (Legal Business Name): REBECCA LYNN CROWELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 N 4TH ST STE 1
OAKLAND MD
21550-1340
US

IV. Provider business mailing address

255 N 4TH ST STE 1
OAKLAND MD
21550-1340
US

V. Phone/Fax

Practice location:
  • Phone: 301-533-1046
  • Fax: 301-533-1049
Mailing address:
  • Phone: 301-533-1046
  • Fax: 301-533-1049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberH72991
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6952
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberH72991
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: