Provider Demographics
NPI:1861601650
Name:CRANK, MICHELLE CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CHRISTINE
Last Name:CRANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11002 VEIRS MILL RD STE 414
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5919
Mailing Address - Country:US
Mailing Address - Phone:301-962-5800
Mailing Address - Fax:301-962-9585
Practice Address - Street 1:11002 VEIRS MILL RD STE 414
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-5919
Practice Address - Country:US
Practice Address - Phone:301-962-5800
Practice Address - Fax:301-962-9585
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069324207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026132OtherINSTITUTIONAL PERMIT