Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 37098 | MN |
NPI | 1073594123 |
---|---|
Provider Name | Jurgen Craig-Mueller |
First Address | Hyannis, MA 02601-2324 |
Second Address | Hyannis, MA 02601-2324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 15/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1006227 | PREFERRED ONE (01) | |
110894 | U CARE (01) | |
209925400 | MEDICAL ASSISTANCE (01) | |
2114032 | FIRST HEALTH PLAN (01) | |
3200835 | MEDICA HEALTH PLANS (01) | |
37098 | LICENSE NUMBER (01) | MN |
600906 | ARAZ GROUP AMERICAS PPO (01) | |
6D059CR | BLUE CROSS BLUE SHIELD (01) | |
BC4093338 | DEA (01) | |
F87747 | (02) | |
HP25409 | HEALTH PARTNERS (01) |