Healthcare Provider Details

I. General information

NPI: 1265921936
Provider Name (Legal Business Name): MADISON CROCKER PIOTROWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON ASHLEY CROCKER

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PROVIDENCE RD STE 100
CHAPEL HILL NC
27514-2203
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone: 855-501-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2019-02560
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: