Provider Demographics
NPI:1952376261
Name:CRAINE, GARY L (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:CRAINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3501 N SCOTTSDALE RD
Mailing Address - Street 2:250
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5648
Mailing Address - Country:US
Mailing Address - Phone:480-941-5266
Mailing Address - Fax:480-941-1174
Practice Address - Street 1:3501 N SCOTTSDALE RD
Practice Address - Street 2:250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5648
Practice Address - Country:US
Practice Address - Phone:480-941-5266
Practice Address - Fax:480-941-1174
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-08-11
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Provider Licenses
StateLicense IDTaxonomies
AZ13396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD36718Medicare UPIN
AZ21904Medicare ID - Type Unspecified