Provider Demographics
NPI:1245573989
Name:CRAIG, GRACE CHUANG (DPM)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:CHUANG
Last Name:CRAIG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29946 TAMARACK TRL
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5144
Mailing Address - Country:US
Mailing Address - Phone:408-628-8102
Mailing Address - Fax:
Practice Address - Street 1:2880 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3209
Practice Address - Country:US
Practice Address - Phone:440-333-5888
Practice Address - Fax:440-333-6766
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1245573989213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery