Provider Demographics
NPI:1609867456
Name:HOWARD, CRAIG MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MARTIN
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 PALISADE PATH
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-8555
Mailing Address - Country:US
Mailing Address - Phone:651-436-6565
Mailing Address - Fax:
Practice Address - Street 1:1303 PALISADE PATH
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-8555
Practice Address - Country:US
Practice Address - Phone:651-436-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN388593300Medicaid
WI30814600Medicaid
MN388593300Medicaid
MNA94636Medicare UPIN
MN080013986Medicare PIN