Provider Demographics
NPI:1386748895
Name:CREELY, BRIAN CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:CREELY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4228 HOUMA BOULEVARD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5406
Mailing Address - Country:US
Mailing Address - Phone:504-264-9353
Mailing Address - Fax:504-301-9312
Practice Address - Street 1:4228 HOUMA BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3000
Practice Address - Country:US
Practice Address - Phone:504-264-9353
Practice Address - Fax:504-301-9312
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA09213R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5W834Medicare ID - Type Unspecified
LAG27779Medicare UPIN