Individual
MARTHA H CRENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1805 PARKE PLAZA CIR, SUITE 101, STONE MOUNTAIN, GA 30087-3498
(770) 469-7000
(770) 879-0436
Mailing address
1805 PARKE PLAZA CIR, SUITE 101, STONE MOUNTAIN, GA 30087-3498
(770) 469-7000
(770) 879-0436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
023580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00247024A1
—
GA
01
—
0528626
AETNA
GA
01
—
080027160
RAILROAD MEDICARE
GA
01
—
151302
BLUE CROSS BLUE SHIELD
GA
Enumeration date
09/01/2005
Last updated
02/17/2010
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