Individual
PAUL T CREEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
516 DIVISION ST, SUITE 120, CEDAR FALLS, IA 50613-2382
(319) 266-0345
Mailing address
999 HOME PLZ, SUITE 100, WATERLOO, IA 50701-4822
(319) 236-0815
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01870
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117267
—
IA
01
—
18418
BLUE CROSS BLUE SHIELD
IA
01
—
410027324
MEDICARE ID
IA
01
—
CG4244
MEDICARE ID
IA
Enumeration date
01/16/2007
Last updated
12/22/2009
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