Individual
DR. NICHOLAS WADE CREASAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(740) 383-8473
(740) 383-8695
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01071917A
IN
207Q00000X
Family Medicine Physician
125745
OH
207R00000X
Internal Medicine Physician
01071917A
IN
207R00000X
Internal Medicine Physician
125745
OH
208M00000X
Hospitalist Physician
Primary
125745
OH
Other
Enumeration date
03/23/2011
Last updated
10/01/2021
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