MEDICARE: DR. BRUCE SCOTT CRAWFORD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	9891	NV
2	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	9891	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780662601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE SCOTT CRAWFORD MD

Provider Business Mailing Address
First Line	:	645 SIERRA ROSE DR
Second Line	:	#204
City	:	RENO
State	:	NV
Zip	:	89511-2060
Country	:	US
Telephone Number	:	775-352-9355
Fax Number	:	775-352-3575

Provider Business Practice Location Address
First Line	:	645 SIERRA ROSE DR STE 204
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2060
Country	:	US
Telephone Number	:	775-352-9355
Fax Number	:	775-352-3575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	11/10/2015

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