Individual
ETHAN KENJI CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 N MAPLEMERE RD STE 100, WILLIAMSVILLE, NY 14221-3182
(716) 833-7112
Mailing address
111 N MAPLEMERE RD STE 100, WILLIAMSVILLE, NY 14221-3182
(716) 833-7112
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
327603
NY
208600000X
Surgery Physician
ME162962
FL
Other
Enumeration date
04/20/2018
Last updated
10/31/2024
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