Provider Demographics
NPI:1457553364
Name:LOUISY, CRAIG LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:LOUIS
Last Name:LOUISY
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 1:9715 MEDICAL CENTER DR
Mailing Address - Street 2:#233
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3320
Mailing Address - Country:US
Mailing Address - Phone:240-403-0621
Mailing Address - Fax:
Practice Address - Street 1:9715 MEDICAL CENTER DR
Practice Address - Street 2:#233
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3320
Practice Address - Country:US
Practice Address - Phone:240-403-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246689208600000X
NC2009-02030208600000X
MDD0064692208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014828800Medicaid
1621956OtherAETNA HMO
3556979OtherCIGNA
6667OtherELDER HEALTH
7104883OtherAETNA PPO
217536OtherJHH
90333701OtherBCBS OF MARYLAND
0008OtherBLUE CROSS OF DC
0008OtherBLUE CROSS OF DC