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NPI Code Detail

MEDICARE: DR. THOMAS L CRAIG III M.D.

MEDICARE:  DR. THOMAS L CRAIG III 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
1173000000XLegal Medicine35057208OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000496395OTHEROHBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922006584
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS L CRAIG III M.D.
Provider Business Mailing Address
First Line : 2225 NOBLE RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44112-1726
Country : US
Telephone Number : 216-761-0330
Fax Number : 216-761-0344
Provider Business Practice Location Address
First Line : 2225 NOBLE RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44112-1726
Country : US
Telephone Number : 216-761-0330
Fax Number : 216-761-0344
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 08/18/2010

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