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Individual

DR. JONATHAN MICHAEL MCCREA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
121 S SAINT LOUIS BLVD, SOUTH BEND, IN 46617-2924
(574) 233-3123
(574) 233-3125
Mailing address
121 S SAINT LOUIS BLVD, SOUTH BEND, IN 46617-2924
(574) 233-3123
(574) 233-3125

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01072365A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201155790
IN
Enumeration date
06/29/2008
Last updated
11/26/2014
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