Provider Demographics
NPI:1699795682
Name:CRAVEN, DANIEL I (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:I
Last Name:CRAVEN
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7700
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0702582080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221008OtherUNISON
PA0019392970001OtherPA MEDICAID
OH0273841Medicaid
OH2326721OtherAETNA
OH000000525892OtherANTHEM
MI1699795682Medicaid
OH725084OtherBUCKEYE
OH000000026879OtherANTHEM
OH363448OtherWELLCARE
OH0273841OtherBCMH
MI1699795682Medicaid
OHCR0808573Medicare PIN
OHCR0808571Medicare PIN