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Individual

SHANE CREAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
47149 BUSE RD, PATUXENT RIVER, MD 20670-1540
(301) 342-1418
Mailing address
47149 BUSE RD, PATUXENT RIVER, MD 20670-1540

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0102208199
VA
171000000X
Military Health Care Provider
208D00000X
General Practice Physician
Primary
0102208199
VA

Other

Enumeration date
02/07/2022
Last updated
07/15/2024
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