Individual
DR. CRAIG S GRAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
104 MANCHESTER PL, BRISTOL, TN 37620-6632
(423) 573-1988
Mailing address
104 MANCHESTER PL, BRISTOL, TN 37620-6632
(423) 573-1988
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0102201380
VA
207R00000X
Internal Medicine Physician
Primary
0102201380
VA
207R00000X
Internal Medicine Physician
DO1918
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004735D11
TRAILBLAZER PART B MEDICA
VA
05
—
010079641
—
VA
05
—
1013942739
—
VA
01
—
1213334
CHA
VA
01
—
144500
ANTHEM BLUE CROSS
VA
05
—
1506538
—
TN
05
—
7100142630
—
KY
01
—
7267547
AETNA
VA
01
—
TN 0104
JOHN DEERE
VA
Enumeration date
07/11/2006
Last updated
04/19/2011
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