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Individual

CRAIG SECOSAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
188 MEDICAL PARK DR., SUITE C, BREVARD, NC 28712-3035
(828) 884-7320
(828) 877-6191
Mailing address
188 MEDICAL PARK DR., SUITE C, BREVARD, NC 28712-3035
(828) 884-7320
(828) 877-6191

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29170
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0850447
UNITED HEALTHCARE
01
75174
BLUE CROSS/BLUE SHIELD
NC
05
8975174
NC
01
P00114787
RAILROAD MEDICARE
01
P00153158
MEDICARE RAILROAD CARRIER
NC
Enumeration date
03/21/2006
Last updated
02/28/2008
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