MEDICARE: DR. CRAIG ALLEN PELLER MD

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	207RG0100X	Gastroenterology Physician	ME58287	FL

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	:	1548255953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG ALLEN PELLER MD

Provider Business Mailing Address
First Line	:	5431 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4639
Country	:	US
Telephone Number	:	954-344-2522
Fax Number	:	954-344-9189

Provider Business Practice Location Address
First Line	:	301 NW 84TH AVE
Second Line	:	SUITE 202
City	:	PLANTATION
State	:	FL
Zip	:	33324-1807
Country	:	US
Telephone Number	:	954-370-1841
Fax Number	:	954-370-9586

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	10/10/2012

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Directions to “ DR. CRAIG ALLEN PELLER MD” Practice Location

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