Provider Demographics
NPI:1902512080
Name:CRAIG A. FUELLING, M.D., PLLC
Entity Type:Organization
Organization Name:CRAIG A. FUELLING, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FUELLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-455-3361
Mailing Address - Street 1:3725 S HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-3535
Mailing Address - Country:US
Mailing Address - Phone:734-455-3361
Mailing Address - Fax:734-975-1604
Practice Address - Street 1:3725 S HILL RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-3535
Practice Address - Country:US
Practice Address - Phone:734-455-3361
Practice Address - Fax:734-975-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty