Individual
MARGOT J. CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
221 MAHALANI ST, WAILUKU, HI 96793-2526
(808) 244-9056
Mailing address
221 MAHALANI ST, WAILUKU, HI 96793-2526
(808) 244-9056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25628
AZ
207R00000X
Internal Medicine Physician
DR.52638
CO
208M00000X
Hospitalist Physician
Primary
MD-11935
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023818
KAISER COMMERCIAL NUMBER
CO
01
—
1033217146
BCBSAZ
AZ
01
—
25628
AZ STATE MEDICAL LICENSE
AZ
05
—
471904
—
AZ
05
—
53284364
—
CO
Enumeration date
09/20/2006
Last updated
05/19/2021
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