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Individual

STEVEN ROBERT EDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01071093A
IN
207X00000X
Orthopaedic Surgery Physician
35.090622
OH
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
01071093A
IN
207XS0106X
Orthopaedic Hand Surgery Physician
35.090622
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000766688
ANTHEM
05
0084595
OH
05
201080990
IN
01
P01130654
RAILROAD MEDICARE
Enumeration date
12/03/2007
Last updated
03/10/2016
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