MEDICARE: MR. ANTHONY SCOTT CRAIG PA-C

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	363A00000X	Physician Assistant	0110003320	VA

General Provider Information

NPI Number	:	1750593414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY SCOTT CRAIG PA-C

Provider Business Mailing Address
First Line	:	1885 TERRIER AVE STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23461-2298
Country	:	US
Telephone Number	:	757-953-9893
Fax Number	:	757-953-9852

Provider Business Practice Location Address
First Line	:	1885 TERRIER AVE STE 100
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23461-2298
Country	:	US
Telephone Number	:	757-953-9893
Fax Number	:	757-953-5852

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

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	12/01/2022

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