# DR. GARY CREMEANS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821058439
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 19210 | WV | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 11/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1807508000 | MEDICAID | WV |
| 01 | — | 2182846 | MEDICAID | OH |
| 01 | — | 64009202 | MEDICAID | KY |
| 01 | — | P00073470 | MEDICARE-RR PROVIDER NUMBER | WV |