Individual
DR. SAMARA CRUDUP
Active
Individual
DR. SAMARA CRUDUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036.124522
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036124522
LICENSE NO
IL
05
—
036124522
—
IL
01
—
P01201664
RR MEDICARE
IL
Enumeration date
09/23/2010
Last updated
10/29/2015
Update your record
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