Provider Demographics
NPI:1073582177
Name:WARNER, CRAIG A (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:WARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7033 LOUIS STEPHENS DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6399
Practice Address - Country:US
Practice Address - Phone:919-994-6331
Practice Address - Fax:919-590-6777
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-04-23
Deactivation Date:2024-04-03
Deactivation Code:
Reactivation Date:2024-04-12
Provider Licenses
StateLicense IDTaxonomies
NC200300299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC134UCOtherBLUE CROSS BLUE SHIELD
NC89134UCMedicaid
NC134UCOtherBLUE CROSS BLUE SHIELD
NC134UCOtherBLUE CROSS BLUE SHIELD
NC89134UCMedicaid
NC2017556AMedicare PIN