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NPI Code Detail

MEDICARE: STEVEN ELDRED

MEDICARE: STEVEN ELDRED
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
1175T00000XPeer Specialist52811805VT

General Provider Information

NPI Number : 1093583064
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN ELDRED
Provider Business Mailing Address
First Line : 181 CRAWFORD RD
Second Line :
City : NEWPORT
State : VT
Zip : 05855-6405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 181 CRAWFORD RD
Second Line :
City : NEWPORT
State : VT
Zip : 05855-6405
Country : US
Telephone Number : 802-673-2004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2023
Last Update Date : 12/19/2023

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Directions to “ STEVEN ELDRED ” Practice Location

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