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Individual

CRAIG A GUDAKUNST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2720 S WASHINGTON AVE, SUITE 300, LANSING, MI 48910-2800
(517) 487-8255
(517) 487-2059
Mailing address
B415 W FEE HALL, EAST LANSING, MI 48824-1315
(517) 353-8470
(517) 432-1074

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS008749L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015577580004
PA
05
1821064528
MI
Enumeration date
02/23/2006
Last updated
10/19/2010
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