MEDICARE: DR. MICHAEL D CRAWFORD M.D.

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	207Y00000X	Otolaryngology Physician	31262	NC
2	207YX0602X	Otolaryngic Allergy Physician	31262	NC

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	:	1790781698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL D CRAWFORD M.D.

Provider Business Mailing Address
First Line	:	1600 PERIMETER PARK DR
Second Line	:	SUITE 225
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8421
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 SMITH CHURCH RD
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-4913
Country	:	US
Telephone Number	:	252-535-2311
Fax Number	:	252-937-4103

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	10/22/2015

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