Provider Demographics
NPI:1558379818
Name:CRAIG, PAMELA HUNT (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:HUNT
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9224
Mailing Address - Country:US
Mailing Address - Phone:831-626-3713
Mailing Address - Fax:
Practice Address - Street 1:23625 HOLMAN HWY
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5902
Practice Address - Country:US
Practice Address - Phone:831-624-5311
Practice Address - Fax:831-625-4948
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30157208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020051035OtherRAILROAD
CAA44311Medicare UPIN
CA00G301570Medicare ID - Type Unspecified