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General NPI Number Information
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NPI Number | 1053635102
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Entity Type | Organization
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Legal Business Name | EDUARDO S CUEVAS MD PS
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 1901 S UNION AVE STE A-114
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City | TACOMA
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State | WA
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Zip | 98405-1702
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Country | US
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Telephone | 253-472-8389
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Fax | 253-472-4977
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Provider Business Mailing Address
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Address Line | 1901 S UNION AVE STE A-114
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City | TACOMA
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State | WA
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Zip | 98405-1702
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Country | US
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Telephone | 253-472-8389
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Fax | 253-472-4977
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Authorized Official
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Title or Position | OWNER
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Name | EDUARDO S CUEVAS
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Credential | MD
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Telephone | 253-472-8389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00029148
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License Number State | WA
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