MEDICARE: DR. ANDREW JACOB CREED MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	04-49298	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	57.247374	OTHER	OH	STATE MEDICAL BOARD OF OHIO
2	94-09541	OTHER	KS	KANSAS BOARD OF HEALING ARTS
3	04-49298	OTHER	KS	KANSAS BOARD OF HEALING ARTS
4	34492	OTHER	NE	NEBRASKA FULL LICENSE

General Provider Information

NPI Number	:	1750878013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JACOB CREED MD

Provider Business Mailing Address
First Line	:	4000 CAMBRIDGE ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8501
Country	:	US
Telephone Number	:	913-588-6970
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8440
Country	:	US
Telephone Number	:	913-588-6970
Fax Number	:	913-588-6965

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2018
Last Update Date	:	08/02/2024

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