Individual
STEVEN C. ELDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
115 W BROADWAY BLVD STE 100, SEDALIA, MO 65301-5708
(660) 951-1091
(660) 951-1046
Mailing address
115 W BROADWAY BLVD STE 100, SEDALIA, MO 65301-5708
(660) 951-1091
(660) 951-1046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R5P86
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080063381
RR MEDICARE
MO
01
—
17996015
BLUE CROSS BLUE SHIELD/KC
MO
01
—
1880
HEALTHCARE USA
MO
05
—
243181609
—
MO
01
—
431592605
MERCY PIN
MO
01
—
5804038
AETNA PIN
MO
Enumeration date
10/12/2005
Last updated
04/08/2019
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