Provider Demographics
NPI:1295876308
Name:CREEL, STEPHEN MELVILLE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MELVILLE
Last Name:CREEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3903
Mailing Address - Country:US
Mailing Address - Phone:781-821-8566
Mailing Address - Fax:
Practice Address - Street 1:238 BAILEY ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-3903
Practice Address - Country:US
Practice Address - Phone:781-821-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA584642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry