Basic Information
| Provider Information | |||||||||
| NPI: | 1073594123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRAIG-MUELLER | ||||||||
| FirstName: | JURGEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030 FALMOUTH RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026012324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7744705080 | ||||||||
| FaxNumber: | 5087756455 | ||||||||
| Practice Location | |||||||||
| Address1: | 1030 FALMOUTH RD | ||||||||
| Address2: | |||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026012324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7744705080 | ||||||||
| FaxNumber: | 5087756455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2005 | ||||||||
| LastUpdateDate: | 08/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 37098 | MN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | BC4093338 | 01 | DEA | OTHER | 110894 | 01 | U CARE | OTHER | 209925400 | 01 | MEDICAL ASSISTANCE | OTHER | 3200835 | 01 | MEDICA HEALTH PLANS | OTHER | 600906 | 01 | ARAZ GROUP AMERICAS PPO | OTHER | 1006227 | 01 | PREFERRED ONE | OTHER | 2114032 | 01 | FIRST HEALTH PLAN | OTHER | 6D059CR | 01 | BLUE CROSS BLUE SHIELD | OTHER | 37098 | 01 | MN | LICENSE NUMBER | OTHER | HP25409 | 01 | HEALTH PARTNERS | OTHER |