Provider Demographics
NPI:1851560288
Name:CRAIG S SCHEIN DPM
Entity Type:Organization
Organization Name:CRAIG S SCHEIN DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:802-748-9400
Mailing Address - Street 1:331 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819
Mailing Address - Country:US
Mailing Address - Phone:802-748-9400
Mailing Address - Fax:802-748-9010
Practice Address - Street 1:331 SUMMER ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819
Practice Address - Country:US
Practice Address - Phone:802-748-9400
Practice Address - Fax:802-748-9010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRAIG S SCHEIN DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-29
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0560000178213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5572620001OtherMEDICARE DME
VT1009116Medicaid
480035210OtherRR MEDICARE
VT5572620001Medicare NSC
VN2932Medicare PIN
480035210OtherRR MEDICARE