# ERIC O SHREDER DO PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124232848
- **Authorized official:** ERIC OTTO SHREDER DO (PHYSICIAN)
- **Authorized official phone:** (480) 926-8000

## Contact information

- **Practice address:** 4838 E BASELINE RD, \#103, MESA, AZ 85206-4671
- **Practice address phone:** (480) 926-8000
- **Practice address fax:** (480) 926-3445
- **Mailing address:** 4838 E BASELINE RD, \#103, MESA, AZ 85206
- **Mailing address phone:** (480) 926-8000
- **Mailing address fax:** (480) 926-3445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3456 | AZ | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 07/24/2008