National Provider Identifier
Ethan Kenji Craig, MD
Ethan Kenji Craig, MD is listed in the NPPES registry with a primary specialty of Surgery Physician in Williamsville, NY and a listed phone number of (716) 833-7112.
Profile Overview
- NPI
- 1114414513
- Provider Type
- Individual
- Primary Specialty
- Surgery Physician
- Enumeration Date
- April 20, 2018
- Last Updated
- October 31, 2024
Practice Location
- 111 N Maplemere RD Ste 100
- Williamsville, NY 14221-3182
Phone: (716) 833-7112
Specialties
- Surgery Physician (208600000X)
- Surgery Physician (208600000X)
Full Record
- NPI
- 1114414513
- Entity Type
- Individual
- Last Name
- Craig
- First Name
- Ethan
- Middle Name
- Kenji
- Credential
- MD
- Mailing Street Address
- 111 N Maplemere RD Ste 100
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-3182
- Mailing Country
- US
- Mailing Phone
- (716) 833-7112
- Practice Street Address
- 111 N Maplemere RD Ste 100
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-3182
- Practice Country
- US
- Practice Phone
- (716) 833-7112
- Enumeration Date
- April 20, 2018
- Last Updated
- October 31, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- October 31, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgery Physician (208600000X), Surgery Physician (208600000X)