Individual
STEPHEN DERRICK EDDY
Active
Individual
STEPHEN DERRICK EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
35084571
OH
207RS0010X
Sports Medicine (Internal Medicine) Physician
PA MD429317
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018294730001
—
PA
05
—
2679632
—
OH
05
—
3810006366
—
WV
01
—
P00428195
MEDICARE RAILROAD
OH
01
—
P00469047
RR MEDICARE
PA
Enumeration date
07/20/2006
Last updated
10/09/2012
Update your record
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