Healthcare Provider Details

I. General information

NPI: 1346974995
Provider Name (Legal Business Name): MR. CRAIG PHILLIP DEUSER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E MEMORIAL DR
MUNCIE IN
47302-4063
US

IV. Provider business mailing address

425 E MEMORIAL DR
MUNCIE IN
47302-4063
US

V. Phone/Fax

Practice location:
  • Phone: 765-288-2157
  • Fax:
Mailing address:
  • Phone: 317-288-2157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26017923A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: