MEDICARE: DR. JAMES ERNEST CRAIGIE 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	208200000X	Plastic Surgery Physician	MD17862	SC
2	2086S0122X	Plastic and Reconstructive Surgery Physician	17862	SC
3	208200000X	Plastic Surgery Physician	17862	SC

General Provider Information

NPI Number	:	1144225228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ERNEST CRAIGIE M.D.

Provider Business Mailing Address
First Line	:	1300 HOSPITAL DR STE 120
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3204
Country	:	US
Telephone Number	:	843-849-8418
Fax Number	:	843-849-8419

Provider Business Practice Location Address
First Line	:	1300 HOSPITAL DR
Second Line	:	STE 120
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3261
Country	:	US
Telephone Number	:	843-388-0660
Fax Number	:	843-849-8419

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	04/02/2024

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