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General NPI Number Information
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NPI Number | 1245523216
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Entity Type | Individual
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Provider Name | ELIZABETH VERA CRAIG MD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 2000 E LAYTON AVE
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City | ST FRANCIS
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State | WI
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Zip | 53235-6053
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Country | US
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Telephone | 414-744-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 W FOREST HOME AVE
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City | MILWAUKEE
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State | WI
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Zip | 53215-2843
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Country | US
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Telephone | 414-389-2377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 73676
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 036.145280
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 51992
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License Number State | TN
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