Provider Demographics
NPI:1447213475
Name:CRELIN, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:CRELIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:721 AMERICAN AVE STE 509
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES WMH ENDOCRINOLOGY
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-5031
Mailing Address - Country:US
Mailing Address - Phone:262-928-9190
Mailing Address - Fax:262-928-9199
Practice Address - Street 1:721 AMERICAN AVE STE 509
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES WMH ENDOCRINOLOGY
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5031
Practice Address - Country:US
Practice Address - Phone:262-928-9190
Practice Address - Fax:262-928-9199
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30195020207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31513800Medicaid
A17386Medicare UPIN
WI000068438Medicare ID - Type Unspecified
WI31513800Medicaid