Individual
WILLIAM MICHAEL CRECELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
421 CHESTNUT ST, EVANSVILLE, IN 47713-1227
(812) 479-6909
(812) 858-4548
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 479-6909
(812) 858-4548
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01044976A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109427
ANTHEM
IN
05
—
200104450
—
IN
Enumeration date
11/28/2006
Last updated
01/02/2013
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