Mary K Craddock, MEDICAL DOCTOR

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

D0044988 Issued in MD

Practice address

5550 Friendship Blvd
Suite 270
Chevy Chase, MD 20815

Phone

(301) 317-0020

Fax

(301) 317-0028

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1205922291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207250639",
            "telephone_number": "301-317-0020",
            "fax_number": "301-317-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 FRIENDSHIP BLVD",
            "address_2": "SUITE 270",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "20815",
            "telephone_number": "301-317-0020",
            "fax_number": "301-317-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0044988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "63790001",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerry Corso, M.S. CCC-SLP
• Sophia Coudenhove-Kalergi, LCSW-C
• Sara Covington Dickson, LGPC
• Daniel Wade Cox, PH.D.
• CPS Partners LLC
• Craig R. Dufresne, M.D., P.C.
• Richele Lynn Creppel, DNP
• Cresenciano C Lopez MD PA
• Cronin Dermatology and Skin Cancer Center, LLC
• Hyland Elizabeth Cronin, M.D.

• Anesthesiology Physician in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.