Provider Demographics
NPI:1902832959
Name:MCGIFFIN, CRAIG W (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:W
Last Name:MCGIFFIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 OCEAN BLVD
Mailing Address - Street 2:104
Mailing Address - City:SOUTHERN SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:27949-3616
Mailing Address - Country:US
Mailing Address - Phone:252-261-3100
Mailing Address - Fax:252-261-3240
Practice Address - Street 1:1 OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHERN SHORES
Practice Address - State:NC
Practice Address - Zip Code:27949-3616
Practice Address - Country:US
Practice Address - Phone:252-261-3100
Practice Address - Fax:252-261-3240
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1902832959Medicare PIN