Individual
GARY STEPHEN CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 MEDICAL VILLAGE DR, UNIT D, WALLACE, NC 28466-1668
(910) 285-7592
(910) 285-4610
Mailing address
125 RIVER VINE PKWY, WALLACE, NC 28466-2377
(910) 285-2134
(910) 285-4610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9401162
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8925388
—
NC
Enumeration date
09/21/2005
Last updated
01/14/2022
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