Healthcare Provider Details

I. General information

NPI: 1194759084
Provider Name (Legal Business Name): MICHAEL J CRAIG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 COVE RD
CANAAN NH
03741
US

IV. Provider business mailing address

55 COVE RD
CANAAN NH
03741-7501
US

V. Phone/Fax

Practice location:
  • Phone: 603-632-1091
  • Fax:
Mailing address:
  • Phone: 603-632-1091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number026340
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number242326
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number17296
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: