Individual
LARRY W CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1450 MATTHEWS TOWNSHIP PKWY, SUITE 300, MATTHEWS, NC 28105-2387
(704) 321-1077
(704) 321-1086
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 321-1077
(704) 321-1086
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
18860
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011V2
—
NC
05
—
8925099
—
NC
Enumeration date
05/23/2005
Last updated
03/11/2015
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