Provider Demographics
NPI:1073512448
Name:CRAIG, STEVEN E (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52733-0523
Mailing Address - Country:US
Mailing Address - Phone:563-242-5763
Mailing Address - Fax:563-242-3922
Practice Address - Street 1:1220 13TH AVE N
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732
Practice Address - Country:US
Practice Address - Phone:563-242-5763
Practice Address - Fax:563-242-3922
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005138213E00000X
IA06600213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1073512448OtherWPS MEDICARE
421472722OtherNONE PROVIDED
IL1285803452OtherADMINISTAR DME
IA1285803452OtherDMERC
IA1073512448OtherNPI
IA0167403Medicaid
IA44122Medicare ID - Type Unspecified
IA0167403Medicaid
421472722OtherNONE PROVIDED