Provider Demographics
NPI:1598743957
Name:DAVIS, CRAIG C (MD, FACP)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 VANDERBILT BEACH RD STE 611
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3510
Mailing Address - Country:US
Mailing Address - Phone:239-304-3030
Mailing Address - Fax:239-643-3030
Practice Address - Street 1:999 VANDERBILT BEACH RD STE 611
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-3510
Practice Address - Country:US
Practice Address - Phone:239-304-3030
Practice Address - Fax:239-643-3030
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D87733Medicare UPIN