Healthcare Provider Details

I. General information

NPI: 1548241730
Provider Name (Legal Business Name): CRAIG M HAUSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W MAIN ST
MIDDLETOWN MD
21769-8005
US

IV. Provider business mailing address

10 W MAIN ST
MIDDLETOWN MD
21769-8005
US

V. Phone/Fax

Practice location:
  • Phone: 240-490-8978
  • Fax:
Mailing address:
  • Phone: 240-490-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0065659
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: