Healthcare Provider Details

I. General information

NPI: 1437123197
Provider Name (Legal Business Name): BARBARA A CROWLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 WATER ST
AUGUSTA ME
04330-4609
US

IV. Provider business mailing address

150 DRESDEN AVE
GARDINER ME
04345-2615
US

V. Phone/Fax

Practice location:
  • Phone: 207-623-2977
  • Fax: 207-626-9374
Mailing address:
  • Phone: 207-626-1063
  • Fax: 207-626-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number012100
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: