Individual
DR. DOUGLAS GORDON CRANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22263
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0577260001
DMERC NUMBER
OR
01
—
110199508
RR MEDICARE PTAN NUMBER
OR
05
—
288488
—
OR
01
—
CD8723
RR MEDICARE GROUP NUMBER
OR
01
—
R0000WFBTV
GROUP PIN NUMBER
OR
Enumeration date
12/21/2005
Last updated
06/03/2025
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