Healthcare Provider Details

I. General information

NPI: 1578771192
Provider Name (Legal Business Name): VALERIE ANN CRAWFORD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 PENTAGON BLVD SUITE 220
BEAVERCREEK OH
45431-1705
US

IV. Provider business mailing address

3535 PENTAGON BLVD SUITE 220
BEAVERCREEK OH
45431-1705
US

V. Phone/Fax

Practice location:
  • Phone: 937-429-7350
  • Fax: 937-439-7400
Mailing address:
  • Phone: 937-429-7350
  • Fax: 937-439-7400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number34007143
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: