Provider Demographics
NPI:1912969874
Name:SURMAN, CRAIG BRUCEHACKETT (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BRUCEHACKETT
Last Name:SURMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:185 ALEWIFE BROOK PKWY
Practice Address - Street 2:STE 2000
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-503-1424
Practice Address - Fax:617-503-1060
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2010-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2068962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H59861Medicare UPIN