Individual
DR. DAVID M CRANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 NASHUA ST, BOSTON, MA 02114
(617) 573-2200
(617) 573-2099
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 573-2621
(617) 573-2769
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
75747
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075747
TUFTS HEALTH PLAN
MA
05
—
3109500
—
MA
01
—
J13759
BCBS MA
MA
Enumeration date
04/22/2006
Last updated
08/01/2012
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