Provider Demographics
NPI:1447351994
Name:SCHEIN, CRAIG S (DPM)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:S
Last Name:SCHEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAINT JOHNS MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5300
Mailing Address - Country:US
Mailing Address - Phone:904-824-0869
Mailing Address - Fax:904-826-0966
Practice Address - Street 1:1 SAINT JOHNS MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5300
Practice Address - Country:US
Practice Address - Phone:904-824-0869
Practice Address - Fax:904-826-0966
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0560000178213E00000X
FLPO1827213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00058802OtherBCBS
480035210OtherRR MEDICARE
67484OtherCIGNA NH
VT1009116Medicaid
03Y004127VT02OtherANTHEM BCBS
5572620001OtherMEDICARE DHE
392204OtherMVP
4859189OtherCIGNA
T55622Medicare UPIN