Provider Demographics
NPI:1750878013
Name:CREED, ANDREW JACOB (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JACOB
Last Name:CREED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4000 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-6970
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8440
Practice Address - Country:US
Practice Address - Phone:913-588-6970
Practice Address - Fax:913-588-6965
Is Sole Proprietor?:No
Enumeration Date:2018-04-21
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-492982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH57.247374OtherSTATE MEDICAL BOARD OF OHIO
KS94-09541OtherKANSAS BOARD OF HEALING ARTS
KS04-49298OtherKANSAS BOARD OF HEALING ARTS
NE34492OtherNEBRASKA FULL LICENSE