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General NPI Number Information
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NPI Number | 1811439821
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Entity Type | Individual
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Provider Name | SHAUN R CRAIG PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 505 INDEPENDENCE RD
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-7916
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Country | US
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Telephone | 610-402-8900
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Fax | 570-420-1704
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Provider Business Mailing Address
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Address Line | 2100 MACK BLVD FL 4
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City | ALLENTOWN
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State | PA
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Zip | 18103-5622
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Country | US
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Telephone | 484-884-4500
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1895
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA064862
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License Number State | PA
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