Provider Demographics
NPI:1831272608
Name:SCHADE, CRAIG RUSSELL (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:RUSSELL
Last Name:SCHADE
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 1:100 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-2317
Mailing Address - Country:US
Mailing Address - Phone:412-922-5570
Mailing Address - Fax:
Practice Address - Street 1:100 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-2317
Practice Address - Country:US
Practice Address - Phone:412-922-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC5915L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU65439Medicare UPIN