Individual
GRACE CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 729-5922
Mailing address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 481-6791
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
060571
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02641514
—
NY
05
—
1174584221
—
VA
01
—
223858253
TAX ID
VA
Enumeration date
03/29/2006
Last updated
11/05/2019
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