# DR. ERIC OTTO SHREDER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1982712519
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | DO3456 | AZ | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 06/21/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2Z3699 | HEALTHNET | AZ |
| 01 | — | 973281 | AHCCCS | AZ |
| 01 | — | AZ071-6830 | BCBS | AZ |