Basic Information
| Provider Information | |||||||||
| NPI: | 1447202825 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLEVELAND | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | PURCELL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 BRIDLE CV | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410019106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135439927 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6460 HARRISON AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139414999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 07/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-047750 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.