Russell Wayne Craig, DO

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

5101011400 Issued in MI

Practice address

17901 Hall Rd
Macomb TWP, MI 48044

Phone

(586) 412-0900

Fax

(586) 412-9767

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• United Rehab Services, P.C.

  • Physical Therapy Clinic/Center
  • Clarkston, MI
  • NPI 1568495083
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1508979436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 HALL RD",
            "city": "MACOMB TWP",
            "state": "MI",
            "postal_code": "48044",
            "telephone_number": "586-412-0900",
            "fax_number": "586-412-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 HALL RD",
            "city": "MACOMB TWP",
            "state": "MI",
            "postal_code": "48044",
            "telephone_number": "586-412-0900",
            "fax_number": "586-412-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "RUSSELL",
        "middle_name": "WAYNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101011400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "5500330",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3385222",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan P Peter DO PC
• Ulrike Doris Bierkamp, A.T.,C.
• Robert Cartwright
• Danny Taylor D.C.P.C.
• Henry Ford Health System North Macomb MRT Center LLC
• Lisa Ann Marlow, MACCC A
• Paula Kay Schreck, MD
• Vikas Suri, RPT

• All providers in Macomb TWP, MI
• Otolaryngology/Facial Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.