Craddock, Larry W

Craddock, Larry W is an individual health care provider with primary practice located at 1450 Matthews Township Pkwy Suite 300, Matthews NC 28105-2387. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Craddock, Larry W can be contacted via phone (704) 321-1077.

Contact Information

Primary practice address
1450 Matthews Township Pkwy Suite 300 Matthews NC 28105-2387
Phone: (704) 321-1077
Fax: (704) 321-1086
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 18860 North Carolina

Profile Details

NPI number 1356344394
LBN Legal business name Craddock, Larry W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Mar 11th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356344394 NPPES
North Carolina MEDICAID 89011V2
North Carolina MEDICAID 8925099

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