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Individual

GLEN H CRAWFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
822 PINE ST, SUITE 2A, PHILADELPHIA, PA 19107-6187
(267) 519-0154
(267) 519-0597
Mailing address
822 PINE ST, SUITE 2A, PHILADELPHIA, PA 19107-6187
(267) 519-0154
(267) 519-0597

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD421221
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1008871430001
PA
Enumeration date
07/13/2006
Last updated
08/28/2015
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