Individual
RUSSELL WAYNE CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
17901 HALL RD, MACOMB TWP, MI 48044
(586) 412-0900
(586) 412-9767
Mailing address
17901 HALL RD, MACOMB TWP, MI 48044
(586) 412-0900
(586) 412-9767
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
5101011400
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3385222
—
MI
01
—
5500330
BCBS OF MI
MI
Enumeration date
08/16/2006
Last updated
01/14/2010
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