Provider Demographics
NPI:1740339027
Name:MEADOWS, CRAIG L (DDS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:L
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-2841
Mailing Address - Country:US
Mailing Address - Phone:304-267-3928
Mailing Address - Fax:304-267-4618
Practice Address - Street 1:111 TAVERN RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2841
Practice Address - Country:US
Practice Address - Phone:304-267-3928
Practice Address - Fax:304-267-4618
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV208081566Medicare UPIN