Provider Demographics
NPI:1073512448
Name:CRAIG, STEVEN E (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7495 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-2013
Mailing Address - Country:US
Mailing Address - Phone:801-213-9400
Mailing Address - Fax:
Practice Address - Street 1:7495 S STATE ST
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-2013
Practice Address - Country:US
Practice Address - Phone:801-213-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06600213E00000X
IL016-005138213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1073512448OtherNPI
IL1285803452OtherADMINISTAR DME
421472722OtherNONE PROVIDED
IL1073512448OtherWPS MEDICARE
IA0167403Medicaid
IA1285803452OtherDMERC
IA44122Medicare ID - Type Unspecified
IA0167403Medicaid
421472722OtherNONE PROVIDED