Healthcare Provider Details

I. General information

NPI: 1073552485
Provider Name (Legal Business Name): MARY RATCHFORD CROSSWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY-FRAN R. CROSWELL

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 WHITE HORSE RD
GREENVILLE SC
29611-6120
US

IV. Provider business mailing address

300 E MCBEE AVE STE 300
GREENVILLE SC
29601-2899
US

V. Phone/Fax

Practice location:
  • Phone: 864-331-0560
  • Fax: 864-241-9277
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number22888
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: