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Individual
DR. CRAIG STEWART TENZER
Active
Individual
DR. CRAIG STEWART TENZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD 1980
MA
213EP1101X
Primary Podiatric Medicine Podiatrist
PD 1980
MA
213ER0200X
Radiology Podiatrist
PD 1980
MA
213ES0000X
Sports Medicine Podiatrist
PD 1980
MA
213ES0103X
Foot & Ankle Surgery Podiatrist
PD 1980
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043282327
TAX IDENTIFICATION NUMBER
MA
01
—
Y70957
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
10/31/2005
Last updated
09/15/2011
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