Provider Demographics
NPI:1346974995
Name:DEUSER, CRAIG PHILLIP
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:PHILLIP
Last Name:DEUSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47302-4063
Mailing Address - Country:US
Mailing Address - Phone:317-288-2157
Mailing Address - Fax:
Practice Address - Street 1:425 E MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47302-4063
Practice Address - Country:US
Practice Address - Phone:765-288-2157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017923A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist