Organization
MAIN STREET FAMILY MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER D CRANE D.O. (PHYSICIAN)
(609) 561-2518
Entity
Organization
Contact information
Practice address
111 VINE ST, HAMMONTON, NJ 08037-1447
(609) 561-2518
Mailing address
111 VINE ST, HAMMONTON, NJ 08037-1447
(609) 561-2518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB42970
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3411001
—
NJ
Enumeration date
12/05/2006
Last updated
04/18/2008
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