Healthcare Provider Details

I. General information

NPI: 1255373429
Provider Name (Legal Business Name): STEVEN ESHELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N 3RD ST STE 3
MARYSVILLE KS
66508-1497
US

IV. Provider business mailing address

PO BOX 747
MANHATTAN KS
66505-0747
US

V. Phone/Fax

Practice location:
  • Phone: 785-562-7805
  • Fax: 785-561-3930
Mailing address:
  • Phone: 785-587-4300
  • Fax: 785-587-4377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number04-20701
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: