Individual
STEPHEN R AUFDERHEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 RIVERBEND DR, SPRINGFIELD, OR 97477-8800
(541) 222-3154
Mailing address
PO BOX 7247, SPRINGFIELD, OR 97475-0011
(541) 686-9551
(541) 687-6716
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD 24931
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232817
—
OR
01
—
A053
TRICARE
OR
01
—
P0089022
RAILROAD MEDICARE
OR
Enumeration date
07/03/2006
Last updated
06/07/2012
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