Provider Demographics
NPI:1487775532
Name:SPRENGER, CRAIG R (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:R
Last Name:SPRENGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3518 30TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8880
Mailing Address - Country:US
Mailing Address - Phone:701-461-8217
Mailing Address - Fax:701-239-4955
Practice Address - Street 1:4801 AMBER VALLEY PARKWAY
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8632
Practice Address - Country:US
Practice Address - Phone:701-461-8217
Practice Address - Fax:701-239-4955
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G07161Medicare UPIN