Individual
DR. CRAIG S SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
646 HARTNESS RD, STATESVILLE, NC 28677-3423
(704) 872-4108
(704) 873-6517
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 873-6517
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2006-01037
NC
207W00000X
Ophthalmology Physician
37314-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000293958
UNISON HEALTH PLAN SC
SC
01
—
01152096
AMERIGROUP COMMUNITY CARE
SC
01
—
1447C
BCBS NC
NC
01
—
199111
MEDCOST
NC
01
—
20096155
SELECT HEALTH OF SC
SC
01
—
2687
EVOLUTIONS
NC
05
—
5906409
—
NC
01
—
7405845
AETNA
NC
01
—
81899
CHC CARES OF SC
SC
01
—
P00421356
RAILROAD MEDICARE
SC
05
—
Q37006
—
SC
Enumeration date
01/19/2006
Last updated
03/30/2021
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