NPI
Beretta Craft-Coffman
NPI 1285601880
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- P.A.-C
- Type
- Individual
- Enumeration date
- 2006-03-02
- Last updated
- 2025-06-20
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Specialties
Licenses
- License CO
- PA.0004259
- License FL
- PA9106348
- License NV
- PA2198
- License NC
- 0010-10058
- License MS
- PA00325
- License SC
- 1199
- License NV
- PA0659
- License TN
- PA0000001672
- License TX
- PA09999
- License VA
- 0110007147
- License GA
- 002366
Location
- Practice location
- 125 Oakside Ct Ste 102
- City
- Canton GA
- Postal code
- 30114-2498
- Phone
- (770) 213-8376
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Canton, GA. 1,790 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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