Provider Demographics
NPI:1821099631
Name:CREALESE, STEVEN JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:CREALESE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 PLUM RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5633
Mailing Address - Country:US
Mailing Address - Phone:704-846-4241
Mailing Address - Fax:
Practice Address - Street 1:1511 PLUM RIDGE CT
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5633
Practice Address - Country:US
Practice Address - Phone:704-846-4241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890846BMedicaid
NCT64509Medicare UPIN
NC890846BMedicaid