Provider Demographics
NPI:1871792036
Name:CRENSHAW, LINDSAY GOULD (MD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:GOULD
Last Name:CRENSHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:GOULD
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:201 E GROVER ST
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3917
Mailing Address - Country:US
Mailing Address - Phone:980-487-3000
Mailing Address - Fax:
Practice Address - Street 1:201 E GROVER ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3917
Practice Address - Country:US
Practice Address - Phone:980-487-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01932207P00000X
SCLL29901207P00000X
GA063201207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921939Medicaid
NC5921939Medicaid