Individual
PATRICIA KAY CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-5000
Mailing address
600 N WOLFE ST, HALSTEAD 600, BALTIMORE, MD 21287-0005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C05497
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05497
MARYLAND BOARD OF PHYSICIAN LICENSE
MD
Enumeration date
09/02/2014
Last updated
04/05/2024
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