Provider Demographics
NPI:1215920764
Name:MILFORD, CREAGH E (DO)
Entity type:Individual
Prefix:DR
First Name:CREAGH
Middle Name:E
Last Name:MILFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6889 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1658
Mailing Address - Country:US
Mailing Address - Phone:248-666-5200
Mailing Address - Fax:248-666-5069
Practice Address - Street 1:6889 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1658
Practice Address - Country:US
Practice Address - Phone:248-666-5200
Practice Address - Fax:248-666-5069
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICM006799207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB44586OtherHEALTH ALLIANCE PLAN
MIC4167OtherM-CARE
MI4573657Medicaid
MI310F007240OtherBCBSM CMG
MI5630642OtherBCBSM
MI0F31072OtherBCBSM COMMON PROV ID
MI106339OtherCARE CHOICES
MI1893975Medicaid
MI1893975Medicaid
MI0F31072OtherBCBSM COMMON PROV ID