Provider Demographics
NPI:1922006584
Name:CRAIG, THOMAS L III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:CRAIG
Suffix:III
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 1:2225 NOBLE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1726
Mailing Address - Country:US
Mailing Address - Phone:216-761-0330
Mailing Address - Fax:216-761-0344
Practice Address - Street 1:2225 NOBLE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44112-1726
Practice Address - Country:US
Practice Address - Phone:216-761-0330
Practice Address - Fax:216-761-0344
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057208173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000496395OtherBLUE CROSS BLUE SHIELD
OH0816915Medicaid
OH000000496395OtherBLUE CROSS BLUE SHIELD