Individual
CRAIG M MINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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