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NPI Code Detail

MEDICARE: WENDELL CRAIG ELDRIDGE MD

MEDICARE: WENDELL CRAIG ELDRIDGE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician35089045OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558562314
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDELL CRAIG ELDRIDGE MD
Provider Business Mailing Address
First Line : 885 N SANDUSKY AVE
Second Line :
City : UPPER SANDUSKY
State : OH
Zip : 43351-1098
Country : US
Telephone Number : 419-294-4991
Fax Number : 419-209-0278
Provider Business Practice Location Address
First Line : 420 SUPERIOR ST
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-1849
Country : US
Telephone Number : 419-626-5623
Fax Number : 419-626-8778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 08/05/2019

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Directions to “ WENDELL CRAIG ELDRIDGE MD” Practice Location

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