MEDICARE: SHARON CRAIG LM, MMID

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	225	CA

General Provider Information

NPI Number	:	1073763512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON CRAIG LM, MMID

Provider Business Mailing Address
First Line	:	2872 ARLINGTON PL
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94555-1437
Country	:	US
Telephone Number	:	510-812-4738
Fax Number	:

Provider Business Practice Location Address
First Line	:	2872 ARLINGTON PL
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94555-1437
Country	:	US
Telephone Number	:	510-812-4738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2008
Last Update Date	:	09/21/2008

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