Individual
DAVID C CRAFTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3660 VISTA AVE, SAINT LOUIS, MO 63110-2540
(314) 977-6125
Mailing address
3691 RUTGER ST, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63110-2515
(314) 977-6828
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R6857
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201188802
—
MO
Enumeration date
10/11/2006
Last updated
07/08/2007
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