Individual
CRYSTAL ANTREASE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2021 BRIDGEMILL DR, SUITE 102, FORT MILL, SC 29707
(704) 594-1140
(219) 209-5611
Mailing address
2021 BRIDGEMILL DR, SUITE 102, FORT MILL, SC 29707
(704) 594-1140
(219) 209-5611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32570
SC
207Q00000X
Family Medicine Physician
44539
TN
Other
Enumeration date
03/16/2007
Last updated
12/09/2020
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