| Eric O Shreder Do Pllc | |
|
4838 E Baseline Rd #103 Mesa AZ 85206-4671 | |
| (480) 926-8000 | |
| (480) 926-3445 |
| Full Name | Eric O Shreder Do Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4838 E Baseline Rd, Mesa, Arizona |
| Authorized Official Name and Position | Eric Otto Shreder (PHYSICIAN) |
| Authorized Official Contact | 4809268000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric O Shreder Do Pllc 4838 E Baseline Rd #103 Mesa AZ 85206 Ph: (480) 926-8000 | Eric O Shreder Do Pllc 4838 E Baseline Rd #103 Mesa AZ 85206-4671 Ph: (480) 926-8000 |
| NPI Number | 1124232848 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 07/24/2008 |
| Medicare PECOS PAC ID | 6002848629 |
|---|---|
| Medicare Enrollment ID | O20090323000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124232848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3456 (Arizona) | Primary |
| Provider Name | Eric O Shreder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982712519 PECOS PAC ID: 7911939533 Enrollment ID: I20050903000021 |
| Provider Name | Sarah Derubeis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912208430 PECOS PAC ID: 4284959503 Enrollment ID: I20150209001403 |
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