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Individual
GREGORY CREEL
Active
Individual
GREGORY CREEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
644
WV
363A00000X
Physician Assistant
Primary
102162
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00248120
RAILROAD MEDICARE
WV
Enumeration date
06/05/2006
Last updated
06/04/2015
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