Individual
MARY K CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Contact information
Practice address
5550 FRIENDSHIP BLVD, SUITE 270, CHEVY CHASE, MD 20815
(301) 317-0020
(301) 317-0028
Mailing address
PO BOX 639, LAUREL, MD 20725-0639
(301) 317-0020
(301) 317-0028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0044988
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63790001
BS
DC
Enumeration date
10/05/2006
Last updated
06/16/2008
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