Provider Demographics
NPI:1265449649
Name:HASEMAN, CRAIG E (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:E
Last Name:HASEMAN
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:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-868-0530
Mailing Address - Fax:812-868-2188
Practice Address - Street 1:1033 E MOUNT PLEASANT RD
Practice Address - Street 2:SUITE D
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7149
Practice Address - Country:US
Practice Address - Phone:812-868-0530
Practice Address - Fax:812-868-2188
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051057A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200173920Medicaid
IN000000197565OtherANTHEM
IN930103217OtherRAILROAD MEDICARE
IN200173920Medicaid
IN941190444Medicare ID - Type Unspecified