Individual
DR. CRAIG RAYMOND PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19725 SOUTH GREENO ROAD, FAIRHOPE, AL 36532-3843
(251) 990-1930
(251) 990-1931
Mailing address
19725 SOUTH GREENO RD, FAIRHOPE, AL 36532-3843
(251) 990-1930
(251) 990-1931
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
18762
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000008091
BLUE CROSS BLUE SHIELD
AL
05
—
000008091
—
AL
05
—
529918300
—
AL
Enumeration date
05/26/2006
Last updated
05/01/2008
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