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Individual

BRIAN R CRICHLOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
204 BECKER DR, ROANOKE RAPIDS, NC 27870-3134
(252) 537-8193
(252) 537-0589
Mailing address
204 BECKER DR, ROANOKE RAPIDS, NC 27870-3134
(252) 537-8193
(252) 537-0589

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101236455
VA
207W00000X
Ophthalmology Physician
Primary
200400660
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010089701
VA
05
010311063
VA
01
137UE
BCBS OF NC
NC
01
146403
ANTHEM BCBS
VA
01
146404
ANTHEM BCBS
VA
05
89137UE
NC
01
I07378
UPIN
Enumeration date
10/17/2006
Last updated
11/11/2020
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