MEDICARE: CRAIG EVAN CHALFIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35079572	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	522374873026	OTHER		CARESOURCE
2	1203168	OTHER		UHC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2638441	OTHER		AETNA
5	0967627001	OTHER		CIGNA
6	522374873	OTHER		TAX ID
7	000000244979	OTHER		ANTHEM
8	10789583	OTHER		CAQH NUMBER
9	R27722	OTHER		NATIONAL PROVIDER ID
10	35079572	OTHER	OH	LICENSE
11	D79572	OTHER		HUMANA

General Provider Information

NPI Number	:	1255318192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG EVAN CHALFIE MD

Provider Business Mailing Address
First Line	:	PO BOX 933432
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0039
Country	:	US
Telephone Number	:	937-641-5072
Fax Number	:	937-641-6129

Provider Business Practice Location Address
First Line	:	3333 W TECH RD STE 220
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-0956
Country	:	US
Telephone Number	:	937-885-4475
Fax Number	:	937-885-3670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	12/04/2024

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Directions to “ CRAIG EVAN CHALFIE MD” Practice Location

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