Provider Demographics
NPI:1306815899
Name:CRAFT, STEVEN W (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:CRAFT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 CROOKED RUN RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-4457
Mailing Address - Country:US
Mailing Address - Phone:304-872-3243
Mailing Address - Fax:
Practice Address - Street 1:324 MILLER MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-1065
Practice Address - Country:US
Practice Address - Phone:304-847-5682
Practice Address - Fax:304-847-5985
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV724208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0056364000Medicaid
WV0056364000Medicaid
WVE93359Medicare UPIN