Provider Demographics
NPI:1700870359
Name:BACHAR, CRAIG M (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:M
Last Name:BACHAR
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 1:23 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-8952
Mailing Address - Country:US
Mailing Address - Phone:941-966-5213
Mailing Address - Fax:941-966-5368
Practice Address - Street 1:23 WEBB ST
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-8952
Practice Address - Country:US
Practice Address - Phone:941-966-5213
Practice Address - Fax:941-966-5368
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22965OtherBLUE CROSS
FL22965OtherBLUE CROSS
FL22965Medicare ID - Type UnspecifiedPROVIDER NUMBER