Provider Demographics
NPI:1942275557
Name:CRAIG, HOLLY DUNCAN (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:DUNCAN
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 WHITNEY AVE
Mailing Address - Street 2:WHITNEY INTERNAL MEDICINE
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3222
Mailing Address - Country:US
Mailing Address - Phone:203-288-9650
Mailing Address - Fax:203-288-9670
Practice Address - Street 1:2440 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3222
Practice Address - Country:US
Practice Address - Phone:203-288-9650
Practice Address - Fax:203-288-9670
Is Sole Proprietor?:No
Enumeration Date:2006-02-18
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT040194OtherCONNECTICARE
CT010040194CT01OtherANTHEM BC BS CT
CT2378769003OtherCIGNA
CT0Q1533OtherHEALTH NET
CT110237405OtherRAILROAD MEDICARE
CT2821859OtherAETNA
CTP2654990OtherOXFORD
CT2821859OtherAETNA
CTH61287Medicare UPIN