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General NPI Number Information
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NPI Number | 1568490415
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Entity Type | Individual
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Provider Name | PATRICK MICHAEL MCELDREW MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NAVAL BRANCH HEALTH CLINIC BLDG 964, NAVAL AIR STATION
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City | JACKSONVILLE
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State | FL
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Zip | 32212
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Country | US
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Telephone | 904-542-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 356 PERTHSHIRE DR
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City | ORANGE PARK
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State | FL
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Zip | 32073-5770
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Country | US
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Telephone | 904-276-6189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101056068
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License Number State | VA
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