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Individual

CRAIG A MCCULLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
333 TAMIAMI TRL S, SUITE 101, VENICE, FL 34285-2402
(941) 488-7716
(941) 488-0511
Mailing address
333 TAMIAMI TRL S, SUITE 101, VENICE, FL 34285-2402
(941) 488-7716
(941) 488-0511

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME59666
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
055156200
FL
01
11954
BCBS
FL
Enumeration date
08/13/2006
Last updated
05/22/2014
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