Individual
DR. LAWRENCE CRYSTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
136 MILL ST, PRINCETON, ME 04668-3344
(207) 796-5503
(207) 796-5528
Mailing address
136 MILL ST, PRINCETON, ME 04668-3344
(207) 796-5503
(207) 796-5528
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD153
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098463
ANTHEM IDENTIFICATION
ME
05
—
111430000
—
ME
01
—
2183024
AETNA PROV #
ME
01
—
48007894
RAILROAD MEDICARE PROV #
ME
Enumeration date
05/04/2006
Last updated
07/14/2022
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