Healthcare Provider Details

I. General information

NPI: 1811962988
Provider Name (Legal Business Name): WENDY J CRAWFORD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY J BOUCHER MD

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL LN
CALAIS ME
04619-1329
US

IV. Provider business mailing address

24 HOSPITAL LN
CALAIS ME
04619-1329
US

V. Phone/Fax

Practice location:
  • Phone: 207-454-8432
  • Fax: 207-454-8333
Mailing address:
  • Phone: 207-454-8432
  • Fax: 207-454-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD21314
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: