Provider Demographics
NPI:1699959833
Name:MARVIN D. CRAIG M.D. PC
Entity type:Organization
Organization Name:MARVIN D. CRAIG M.D. PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-317-7474
Mailing Address - Street 1:4220 LUNA PIER RD
Mailing Address - Street 2:
Mailing Address - City:LUNA PIER
Mailing Address - State:MI
Mailing Address - Zip Code:48157-9796
Mailing Address - Country:US
Mailing Address - Phone:734-317-7474
Mailing Address - Fax:734-317-7476
Practice Address - Street 1:4220 LUNA PIER RD
Practice Address - Street 2:
Practice Address - City:LUNA PIER
Practice Address - State:MI
Practice Address - Zip Code:48157-9796
Practice Address - Country:US
Practice Address - Phone:734-317-7474
Practice Address - Fax:734-317-7476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053651207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty