Provider Demographics
NPI:1851756886
Name:CRAIG, ANDREW MONROE
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MONROE
Last Name:CRAIG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SPRING ST APT 130
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-4458
Mailing Address - Country:US
Mailing Address - Phone:507-358-4065
Mailing Address - Fax:
Practice Address - Street 1:360 SPRING ST APT 130
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-4458
Practice Address - Country:US
Practice Address - Phone:507-358-4065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program