Provider Demographics
NPI:1518930783
Name:RAMBEAU, CRYSTAL B (MD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:B
Last Name:RAMBEAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CRYSTAL
Other - Middle Name:D
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:124 E STEWART ST
Mailing Address - Street 2:
Mailing Address - City:COATS
Mailing Address - State:NC
Mailing Address - Zip Code:27521-8352
Mailing Address - Country:US
Mailing Address - Phone:919-901-7344
Mailing Address - Fax:877-807-8251
Practice Address - Street 1:124 E STEWART ST
Practice Address - Street 2:
Practice Address - City:COATS
Practice Address - State:NC
Practice Address - Zip Code:27521-8352
Practice Address - Country:US
Practice Address - Phone:919-901-7344
Practice Address - Fax:877-807-8251
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904686Medicaid
SCH37908HBMedicare UPIN