Provider Demographics
NPI:1144223868
Name:CRAGO, LORI M (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:M
Last Name:CRAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 533
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-0533
Mailing Address - Country:US
Mailing Address - Phone:231-876-7857
Mailing Address - Fax:231-876-7176
Practice Address - Street 1:7985 MACKINAW TRL
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8111
Practice Address - Country:US
Practice Address - Phone:231-876-6200
Practice Address - Fax:231-779-5290
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2020-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301054265207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI238635Medicare Oscar/Certification