Crandall, Theodore L

Crandall, Theodore L is an individual health care provider with primary practice located at 9930 Grubbs Rd , Wexford PA 15090-9643. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Crandall, Theodore L can be contacted via phone (412) 367-1199.

Contact Information

Primary practice address
9930 Grubbs Rd Wexford PA 15090-9643
Phone: (412) 367-1199
Fax: (412) 367-0216
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD016185E Pennsylvania

Profile Details

NPI number 1821068396
LBN Legal business name Crandall, Theodore L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Apr 3rd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821068396 NPPES
Pennsylvania Other 046321 HIGHMARK BS
Pennsylvania Other 11552705 HIGHMARK BS
Pennsylvania MEDICAID 0608640 HIGHMARK BS
Pennsylvania MEDICAID 0006879180005 HIGHMARK BS

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