Provider Demographics
NPI:1528441094
Name:BURTON, CRAIG STEVEN
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:STEVEN
Last Name:BURTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 SEMINOLE TRL
Mailing Address - Street 2:SUITE 179
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-5637
Mailing Address - Country:US
Mailing Address - Phone:434-242-7200
Mailing Address - Fax:
Practice Address - Street 1:3445 SEMINOLE TRL
Practice Address - Street 2:SUITE 179
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5637
Practice Address - Country:US
Practice Address - Phone:434-242-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver