Provider Demographics
NPI:1700320835
Name:AUKAMP, CRAIG WILLIAM (ATC)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:WILLIAM
Last Name:AUKAMP
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 BUNTING DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1969
Mailing Address - Country:US
Mailing Address - Phone:302-234-2267
Mailing Address - Fax:
Practice Address - Street 1:100 N DUPONT RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-3106
Practice Address - Country:US
Practice Address - Phone:302-651-2609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00001342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEJ3-0000134OtherBOC