Provider Demographics
NPI:1932280989
Name:PIERSTORFF, CRAIG ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:PIERSTORFF
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 1:1229 S 58TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3314
Mailing Address - Country:US
Mailing Address - Phone:414-443-2732
Mailing Address - Fax:
Practice Address - Street 1:1229 S 58TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-3314
Practice Address - Country:US
Practice Address - Phone:414-443-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48896-020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology