Provider Demographics
NPI:1154588051
Name:CROWELL, REBECCA LYNN (DO)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:CROWELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N 4TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1340
Mailing Address - Country:US
Mailing Address - Phone:301-533-1046
Mailing Address - Fax:301-533-1049
Practice Address - Street 1:255 N 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1340
Practice Address - Country:US
Practice Address - Phone:301-533-1046
Practice Address - Fax:301-533-1049
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH72991207VX0000X, 207VM0101X
KS6952207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine