Provider Demographics
NPI:1851388177
Name:CRAWFORD, KEVIN T (DO)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:T
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31535 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1821
Mailing Address - Country:US
Mailing Address - Phone:734-721-8785
Mailing Address - Fax:734-721-2938
Practice Address - Street 1:31535 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1821
Practice Address - Country:US
Practice Address - Phone:734-721-8785
Practice Address - Fax:734-721-2938
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010624207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI113209913Medicaid
E78164Medicare UPIN
MI113209913Medicaid