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NPI Code Detail

MEDICARE: ANDREW J CREAGER MD

MEDICARE: ANDREW J CREAGER 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
1174400000XSpecialistMD426308PA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMD426308PA

General Provider Information

NPI Number : 1831191154
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW J CREAGER MD
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 232 W 25TH ST
Second Line :
City : ERIE
State : PA
Zip : 16544-0002
Country : US
Telephone Number : 814-452-5000
Fax Number : 814-456-4542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/26/2013

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