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NPI Code Detail

MEDICARE: DR. GARY L CRAIG M.D.

MEDICARE: DR. GARY L CRAIG 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
1174400000XSpecialistMD0029482WA

Other Identifiers

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

General Provider Information

NPI Number : 1508936436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY L CRAIG M.D.
Provider Business Mailing Address
First Line : 105 W 8TH AVE
Second Line : STE 6080
City : SPOKANE
State : WA
Zip : 99204-2313
Country : US
Telephone Number : 509-838-6500
Fax Number : 509-838-6561
Provider Business Practice Location Address
First Line : 105 W 8TH AVE
Second Line : STE 6080
City : SPOKANE
State : WA
Zip : 99204-2313
Country : US
Telephone Number : 509-838-6500
Fax Number : 509-838-6561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 02/19/2008

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Directions to “ DR. GARY L CRAIG M.D.” Practice Location

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