Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 0103301140 | VA |
Y | 213ES0131X | Foot Surgery | 0103301140 | VA |
NPI | 1255628350 |
---|---|
Provider Name | Dr. Corine Leigh Creech |
First Address | Baltimore, MD 21297-3174 |
Second Address | Fairfax, VA 22031-4625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2011 |
Last Update Date | 20/10/2020 |