Provider Demographics
NPI:1124384086
Name:CRAIG, JESSICA SAMPIAS (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SAMPIAS
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:SAMPIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5235 KING AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4068
Mailing Address - Country:US
Mailing Address - Phone:443-730-2020
Mailing Address - Fax:
Practice Address - Street 1:5235 KING AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4068
Practice Address - Country:US
Practice Address - Phone:443-730-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0081575208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics