Healthcare Provider Details

I. General information

NPI: 1922078708
Provider Name (Legal Business Name): ANGELA ROSE-MARIE CRANE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 SOUTH RIVER RD.
BEDFORD NH
03110-6547
US

IV. Provider business mailing address

168 SOUTH RIVER RD.
BEDFORD NH
03110-6547
US

V. Phone/Fax

Practice location:
  • Phone: 603-629-1793
  • Fax:
Mailing address:
  • Phone: 603-629-1793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number9315
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9315
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: