Healthcare Provider Details

I. General information

NPI: 1518930783
Provider Name (Legal Business Name): CRYSTAL B RAMBEAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRYSTAL D BAKER M.D.

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E STEWART ST
COATS NC
27521-8352
US

IV. Provider business mailing address

124 E STEWART ST
COATS NC
27521-8352
US

V. Phone/Fax

Practice location:
  • Phone: 919-901-7344
  • Fax: 877-807-8251
Mailing address:
  • Phone: 919-901-7344
  • Fax: 877-807-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2006-00301
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: