Provider Demographics
NPI:1639143027
Name:CRAIG, EDWARD V (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:V
Last Name:CRAIG
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 1:8100 NORTHLAND DRIVE
Mailing Address - Street 2:TRIA ORTHOPAEDIC CENTER
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55431
Mailing Address - Country:US
Mailing Address - Phone:952-977-0492
Mailing Address - Fax:
Practice Address - Street 1:8100 NORTHLAND DRIVE
Practice Address - Street 2:TRIA ORTHOPAEDIC CENTER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55431
Practice Address - Country:US
Practice Address - Phone:952-977-0492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122354207X00000X
CT034854207X00000X
MN108292207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01007020OtherRAILROAD MEDICARE
CTP01040828OtherRAILROAD MEDICARE
NY31J561OtherEMPIRE BCBS
NY31J561OtherEMPIRE BCBS
CTD400056373Medicare PIN