| Doctor Name: | CRANE ANTAWAN NIBLACK |
| NPI Number: | 1568628139 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0101253456 |
| Business Practice Address: | 6802 Paragon Pl Ste Ofc417 Richmond, VA - 232301644 |
| Business Phone Number: | 8046874793 |
| Business Fax Number: | |
| Mailing Address: | 6802 Paragon Pl Ste Ofc417, RICHMOND |
| State: | VA |
| Postal Code: | 232301644 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2008 |
| NPI Last Update Date: | 03/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101253456 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |