Healthcare Provider Details

I. General information

NPI: 1700907086
Provider Name (Legal Business Name): CREIGHTON EDWARD LIKES III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 EXECUTIVE CENTER DR STE 300
GREENVILLE SC
29615-4555
US

IV. Provider business mailing address

700 EXECUTIVE CENTER DR STE 300
GREENVILLE SC
29615-4555
US

V. Phone/Fax

Practice location:
  • Phone: 864-498-1606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number26420
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: