Provider Demographics
NPI:1831503820
Name:CRADDICK, MICHAEL DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:CRADDICK
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1227 E RUSHOLME ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2459
Mailing Address - Country:US
Mailing Address - Phone:563-421-7681
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:1227 E RUSHOLME ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2459
Practice Address - Country:US
Practice Address - Phone:563-421-6610
Practice Address - Fax:563-421-7719
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2021-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IADO-05058207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine