Basic Information
Provider Information
NPI: 1801886106
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEST
FirstName: CRAIG
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 630 PLANTATION ST
Address2: WOT 12TH FL
City: WORCESTER
State: MA
PostalCode: 016052038
CountryCode: US
TelephoneNumber: 5083685529
FaxNumber:  
Practice Location
Address1: 123 SUMMER ST
Address2: SUITE 150 S
City: WORCESTER
State: MA
PostalCode: 016081216
CountryCode: US
TelephoneNumber: 5083683110
FaxNumber: 5083683113
Other Information
ProviderEnumerationDate: 10/27/2005
LastUpdateDate: 05/03/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X74215MAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
308040405MA MEDICAID


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