MEDICARE: DR. JEFFREY CRAVEN M.D.

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	207P00000X	Emergency Medicine Physician	35040954C	OH
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	35040954	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104821206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY CRAVEN M.D.

Provider Business Mailing Address
First Line	:	446 MORGAN ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-2348
Country	:	US
Telephone Number	:	513-834-7063
Fax Number	:	513-873-1567

Provider Business Practice Location Address
First Line	:	6527 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239
Country	:	US
Telephone Number	:	513-834-7063
Fax Number	:	513-873-1567

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/02/2018

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