Healthcare Provider Details

I. General information

NPI: 1679539860
Provider Name (Legal Business Name): CRAIG R STIRRAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 GUEST ST STE 225
BRIGHTON MA
02135-2065
US

IV. Provider business mailing address

300 MOUNT AUBURN ST SUITE 505
CAMBRIDGE MA
02138-5600
US

V. Phone/Fax

Practice location:
  • Phone: 617-738-8642
  • Fax: 617-202-4172
Mailing address:
  • Phone: 617-491-6766
  • Fax: 617-491-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number39425
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number39425
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number39425
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: