Provider Demographics
NPI:1588776173
Name:OLIN, CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:OLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 HIGH RIDGE PARK
Mailing Address - Street 2:SUITE 103
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1332
Mailing Address - Country:US
Mailing Address - Phone:203-276-4644
Mailing Address - Fax:203-276-4090
Practice Address - Street 1:5 HIGH RIDGE PARK
Practice Address - Street 2:SUITE 103
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1332
Practice Address - Country:US
Practice Address - Phone:203-276-4644
Practice Address - Fax:203-276-4090
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT035158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine