Organization
CRATER LAKE EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA BUTCHER (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
1100 11TH ST SW, LIVE OAK, FL 32064-3608
(973) 251-1132
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
(973) 251-1132
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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