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Individual
CRYSTAL SHANELLE DYER
Active
Individual
CRYSTAL SHANELLE DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
0101247662
VA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
44247
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44247
STATE MEDICAL LICENSE
TN
Enumeration date
09/11/2007
Last updated
08/04/2023
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