Individual
AMELIA TAYLOR CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2210 LAURENS RD, GREENVILLE, SC 29607-3224
(864) 288-8289
Mailing address
2210 LAURENS RD, GREENVILLE, SC 29607-3224
(864) 288-8289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2012
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124825A
—
GA
05
—
003124825B
—
GA
05
—
003124825D
—
GA
05
—
003124825E
—
GA
01
—
691178
WELLCARE
GA
01
—
P01064190
RAILROAD MEDICARE
GA
01
—
P01118233
RAILROAD MEDICARE
GA
Enumeration date
04/18/2012
Last updated
07/21/2022
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