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Individual

JERRY E MCCRERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
022578
MN
207R00000X
Internal Medicine Physician
Primary
22578
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0400552
MEDICA
MN
01
1000248
PREFERRED ONE
MN
01
121118D277
UCARE
MN
01
31T05MC
BLUE SHIELD
MN
05
738285500
MN
01
763172
AMERICA'S PPO
MN
01
A009
CHAMPUS
MN
01
HP24911
HEALTH PARTNERS
MN
Enumeration date
01/19/2006
Last updated
07/29/2014
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