Individual
THEODORE L CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9930 GRUBBS RD, WEXFORD, PA 15090-9643
(412) 367-1199
(412) 367-0216
Mailing address
2 HOT METAL ST, QUANTUM ONE, N431, PITTSBURGH, PA 15203-2348
(412) 432-5806
(412) 432-7691
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD016185E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006879180005
—
PA
01
—
046321
HIGHMARK BS
PA
05
—
0608640
—
OH
01
—
11552705
CAQH
PA
Enumeration date
01/25/2006
Last updated
04/03/2009
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