Individual
CRAIG R GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
765 LIBERTY ST, SUITE # 301, MEADVILLE, PA 16335-2566
(814) 724-8363
(814) 724-8343
Mailing address
765 LIBERTY ST, SUITE # 301, MEADVILLE, PA 16335-2566
(814) 724-8363
(814) 724-8343
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS004699L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127917
BLUE CROSS / SHIELD
PA
Enumeration date
07/07/2006
Last updated
02/13/2008
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