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Individual
STEPHEN WARD ETHEREDGE
Active
Individual
STEPHEN WARD ETHEREDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
TRN 13458
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD.205635
LA
Other
Enumeration date
04/29/2009
Last updated
08/26/2022
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