Provider Demographics
NPI:1811931694
Name:CRAIG, WILLIAM DAVID (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:DAVID
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2220 SE OCEAN BLVD.
Mailing Address - Street 2:STE 101
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996
Mailing Address - Country:US
Mailing Address - Phone:772-283-8380
Mailing Address - Fax:772-283-5538
Practice Address - Street 1:2220 SE OCEAN BLVD.
Practice Address - Street 2:STE 101
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996
Practice Address - Country:US
Practice Address - Phone:772-283-8380
Practice Address - Fax:772-283-5538
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS21503207RR0500X
TN859207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3031339OtherBLUE CROSS
SD2008308OtherBLUE CROSS GROUP ID
TNF46806Medicare UPIN
TN3375864Medicare ID - Type UnspecifiedMEDICARE GROUP ID
TN3031339OtherBLUE CROSS