Provider Demographics
NPI:1396857561
Name:REICH, CRAIG A (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:REICH
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:1845 N FARWELL AVE
Mailing Address - Street 2:OAKWOOD FAMILY MEDICAL CLINIC SC
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202
Mailing Address - Country:US
Mailing Address - Phone:414-270-0777
Mailing Address - Fax:414-270-0770
Practice Address - Street 1:1845 N FARWELL AVE
Practice Address - Street 2:OAKWOOD FAMILY MEDICAL CLINIC SC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202
Practice Address - Country:US
Practice Address - Phone:414-270-0777
Practice Address - Fax:414-270-0770
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY36860207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32229800Medicaid
G27263Medicare UPIN