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Individual

CRAIG M MINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2820 MAIN ST W, SNELLVILLE, GA 30078-3156
(770) 978-1422
(770) 978-1423
Mailing address
2820 MAIN ST W, SNELLVILLE, GA 30078-3156
(770) 978-1422
(770) 978-1423

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
01057724A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
058902
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200445180
IN
05
773737921A
GA
Enumeration date
07/12/2005
Last updated
09/02/2021
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