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NPI Code Detail

MEDICARE: DR. STEPHEN ELDER MD

MEDICARE: DR. STEPHEN ELDER 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
1207L00000XAnesthesiology Physician28065WA

Other Identifiers

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

General Provider Information

NPI Number : 1780651299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN ELDER MD
Provider Business Mailing Address
First Line : 3633 PACIFIC AVE
Second Line : SUITE 204
City : TACOMA
State : WA
Zip : 98418-7900
Country : US
Telephone Number : 253-274-1668
Fax Number :
Provider Business Practice Location Address
First Line : 3633 PACIFIC AVE
Second Line : SUITE 204
City : TACOMA
State : WA
Zip : 98418-7900
Country : US
Telephone Number : 253-274-1668
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 10/25/2007

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Directions to “ DR. STEPHEN ELDER MD” Practice Location

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