Provider Demographics
NPI:1255318192
Name:CHALFIE, CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:CHALFIE
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 1:76 REMICK BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8310
Mailing Address - Country:US
Mailing Address - Phone:937-885-4475
Mailing Address - Fax:937-885-3670
Practice Address - Street 1:76 REMICK BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-8310
Practice Address - Country:US
Practice Address - Phone:937-885-4475
Practice Address - Fax:937-885-3670
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079572208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
2638441OtherAETNA
OH35079572OtherLICENSE
R27722OtherNATIONAL PROVIDER ID
0967627001OtherCIGNA
1203168OtherUHC
522374873026OtherCARESOURCE
OH2279510Medicaid
D79572OtherHUMANA
000000244979OtherANTHEM
10789583OtherCAQH NUMBER
10789583OtherCAQH NUMBER
522374873026OtherCARESOURCE