Provider Demographics
NPI:1225374754
Name:CRAIG M LANDWEHR MD APMLLC
Entity Type:Organization
Organization Name:CRAIG M LANDWEHR MD APMLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:LANDWEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-892-2434
Mailing Address - Street 1:71380 HIGHWAY 21
Mailing Address - Street 2:STE 101
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7245
Mailing Address - Country:US
Mailing Address - Phone:985-892-2434
Mailing Address - Fax:
Practice Address - Street 1:71380 HIGHWAY 21
Practice Address - Street 2:STE 101
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7245
Practice Address - Country:US
Practice Address - Phone:985-892-2434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.019911207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty