Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 82984 | GA |
NPI | 1093004616 |
---|---|
Provider Name | Dr. Craig Rodney Mccready |
First Address | Lawrenceville, GA 30046-4303 |
Second Address | Atlanta, GA 30322-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 03/01/2020 |