Provider Demographics
NPI:1598710626
Name:CRAIG, MARIA PANGRAZIA (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIA PANGRAZIA
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7608
Practice Address - Street 1:3151 JOHNSON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2362
Practice Address - Country:US
Practice Address - Phone:740-346-0496
Practice Address - Fax:740-266-3865
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50001758363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0083584Medicaid
OHH216170Medicare UPIN