Provider Demographics
NPI:1730139254
Name:CREAGER, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:CREAGER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS STREET PBB A3
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL CARDIOVASCULAR DIVISION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-5267
Mailing Address - Fax:617-232-2749
Practice Address - Street 1:75 FRANCIS STREET PBB A3
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL CARDIOVASCULAR DIVISION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-5267
Practice Address - Fax:617-232-2749
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-05-21
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Provider Licenses
StateLicense IDTaxonomies
MA40138207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2071932Medicaid