Individual
JAMES MICHAEL CRAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 W GRANADA BLVD, SUITE 4, ORMOND BEACH, FL 32174-8154
(386) 677-8808
(386) 677-2134
Mailing address
1050 W GRANADA BLVD, SUITE 4, ORMOND BEACH, FL 32174-8154
(386) 677-8808
(386) 677-2134
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
25633
KY
207YP0228X
Pediatric Otolaryngology Physician
25633
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040016956
RR MEDICARE PIN
GA
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64047475
—
KY
01
—
CB5773
RR MEDICARE GROUP
GA
Enumeration date
07/10/2006
Last updated
07/16/2012
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