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Individual

WAYNE LEWIS CREELMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-7981
(352) 265-7983
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-7981
(352) 265-7983

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301073771
MI
2084P0800X
Psychiatry Physician
ME93408
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260D176250
BC/BS
MI
05
276092400
FL
05
4109799
MI
Enumeration date
05/09/2006
Last updated
04/28/2008
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