Keanna, Craig Michael
Keanna, Craig Michael is an individual health care provider with primary practice located at 1062 Barnes Rd , Wallingford CT 06492-6012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Keanna, Craig Michael can be contacted via phone (203) 294-6328.Contact Information
Primary practice address
1062 Barnes Rd
Wallingford CT 06492-6012
Phone: (203) 294-6328
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 034961 | Connecticut |
Profile Details
| NPI number | 1881635662 |
|---|---|
| LBN Legal business name | Keanna, Craig Michael |
| Credentials | M.D., F.A.A.P. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2006 |
| Last updated | Feb 16th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881635662 | NPPES |
| Connecticut | MEDICAID | 001349613 |
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