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Individual
DR. WILLIAM D CRECELIUS
Active
Individual
DR. WILLIAM D CRECELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
28795
KY
207P00000X
Emergency Medicine Physician
Primary
G138326
CA
208D00000X
General Practice Physician
28795
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048676
ANTHEM
KY
01
—
10523140
PASSPORT
KY
05
—
200009610
—
IN
01
—
2433207000
PASSPORT ADVANTAGE
KY
05
—
64287956
—
KY
Enumeration date
08/12/2006
Last updated
04/28/2023
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