Provider Demographics
NPI:1902120561
Name:CUMMINGS, CRAIG ELLIOTT (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:ELLIOTT
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W. WISCONSIN AVENUE
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-2715
Mailing Address - Fax:414-259-1522
Practice Address - Street 1:9200 W. WISCONSIN AVENUE
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-2715
Practice Address - Fax:414-259-1522
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56377-20207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400139317Medicare PIN