Organization
MARY K. CRADDOCK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY K CRADDOCK M.D. (PRESIDENT)
(301) 317-0020
Entity
Organization
Contact information
Practice address
5550 FRIENDSHIP BLVD, SUITE 270, CHEVY CHASE, MD 20815-7256
(301) 215-7347
Mailing address
PO BOX 639, LAUREL, MD 20725-0639
(301) 317-0020
(301) 317-0028
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0044988
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6379
CAREFIRST
DC
Enumeration date
08/13/2008
Last updated
08/13/2008
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