Individual
MR. DONALD RUSSEL CRAWFORD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1328 LAKE PARK BLVD N STE 102, CAROLINA BEACH, NC 28428-3906
(910) 399-8666
Mailing address
1328 LAKE PARK BLVD N STE 102, CAROLINA BEACH, NC 28428-3906
(910) 399-8666
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5012657
NC
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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