Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | LL4001 | SC |
N | 111NI0900X | Internist | LL4001 | SC |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 25883 | SC |
N | 207RC0000X | Internist - Cardiovascular Disease | 25883 | SC |
NPI | 1073621934 |
---|---|
Provider Name | Michael L Craig |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
258839 | (05) | SC |
I05793 | (02) |