Individual
RHEA CRAIGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3721 SAINT JOHNS LN, ELLICOTT CITY, MD 21042-5226
(708) 267-3926
Mailing address
7955 TUCKERMAN LN, ROCKVILLE, MD 20854-3243
(708) 267-3926
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036089950
IL
207Q00000X
Family Medicine Physician
Primary
D0077321
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089950
—
IL
01
—
1634566
BCBS PROVIDER ID
IL
01
—
P00418918
RAILROAD MEDICARE
IL
Enumeration date
06/26/2006
Last updated
04/21/2014
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