Crandell, David M

Crandell, David M is an individual health care provider with primary practice located at 125 Nashua St , Boston MA 02114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Crandell, David M can be contacted via phone (617) 573-2200.

Contact Information

Primary practice address
125 Nashua St Boston MA 02114
Phone: (617) 573-2200
Fax: (617) 573-2099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 75747 Massachusetts

Profile Details

NPI number 1215993910
LBN Legal business name Crandell, David M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2006
Last updated Aug 1st, 2012 - about 12 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 1215993910 NPPES
Massachusetts MEDICAID 3109500
Massachusetts Other 075747
Massachusetts Other J13759

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