MEDICARE: CRAIG E COLE 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	207RH0000X	Hematology (Internal Medicine) Physician	4301065532	MI

General Provider Information

NPI Number	:	1700881059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG E COLE MD

Provider Business Mailing Address
First Line	:	804 SERVICE RD STE A109F
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48824-7015
Country	:	US
Telephone Number	:	517-884-2976
Fax Number	:	517-432-3928

Provider Business Practice Location Address
First Line	:	401 W GREENLAWN AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-2819
Country	:	US
Telephone Number	:	517-975-9500
Fax Number	:	517-975-9520

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	02/18/2019

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