Provider Demographics
NPI:1801833660
Name:BARTRUFF, CRAIG DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:DAVID
Last Name:BARTRUFF
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:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-0389
Mailing Address - Country:US
Mailing Address - Phone:308-537-3674
Mailing Address - Fax:308-537-3675
Practice Address - Street 1:619 10TH ST
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-2063
Practice Address - Country:US
Practice Address - Phone:308-537-3674
Practice Address - Fax:308-537-3675
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47061825600Medicaid
NEB90858Medicare UPIN
NE087138Medicare ID - Type Unspecified