Basic Information
| Provider Information | |||||||||
| NPI: | 1598710626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRAIG | ||||||||
| FirstName: | MARIA PANGRAZIA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 380 SUMMIT AVE | ||||||||
| Address2: | MSO PHYSICIAN BILLING | ||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402837597 | ||||||||
| FaxNumber: | 7402837608 | ||||||||
| Practice Location | |||||||||
| Address1: | 3151 JOHNSON RD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403460496 | ||||||||
| FaxNumber: | 7402663865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 08/22/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 50001758 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 0083584 | 05 | OH | MEDICAID |