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Individual

CRAIG WILLIAM FORTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2030 STRINGTOWN RD STE 210, GROVE CITY, OH 43123-3993
(614) 544-0050
Mailing address
5400 FRANTZ RD STE 250, DUBLIN, OH 43016-6102

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-011726
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
34.011726
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0126633
OH
Enumeration date
03/26/2012
Last updated
01/25/2022
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