Individual
DR. ERIC OTTO SHREDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4838 E BASELINE RD, SUITE 103, MESA, AZ 85206-4671
(480) 926-8000
(480) 926-3445
Mailing address
4838 E BASELINE RD, SUITE 103, MESA, AZ 85206-4671
(480) 926-8000
(480) 926-3445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO3456
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z3699
HEALTHNET
AZ
01
—
973281
AHCCCS
AZ
01
—
AZ071-6830
BCBS
AZ
Enumeration date
08/25/2006
Last updated
06/21/2010
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