Provider Demographics
NPI:1093004616
Name:MCCREADY, CRAIG RODNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:RODNEY
Last Name:MCCREADY
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 1:665 DULUTH HWY STE 301
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4303
Mailing Address - Country:US
Mailing Address - Phone:470-325-0159
Mailing Address - Fax:
Practice Address - Street 1:201 DOWMAN DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1007
Practice Address - Country:US
Practice Address - Phone:404-788-3632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA829842086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program