| W. Eric Shrader Md Pc | |
|
986 Ben Bolt Ave Tazewell VA 24651 | |
| (276) 979-1323 | |
| (276) 979-9123 |
| Full Name | W. Eric Shrader Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 986 Ben Bolt Ave, Tazewell, Virginia |
| Authorized Official Name and Position | W Eric Shrader (OWNER) |
| Authorized Official Contact | 2769791323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| W. Eric Shrader Md Pc Po Box 309 Tazewell VA 24651-0309 Ph: (276) 979-1323 | W. Eric Shrader Md Pc 986 Ben Bolt Ave Tazewell VA 24651 Ph: (276) 979-1323 |
| NPI Number | 1194867952 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 11/26/2007 |
| Medicare PECOS PAC ID | 9638129455 |
|---|---|
| Medicare Enrollment ID | O20050128000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194867952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101037561 (Virginia) | Primary |
| Provider Name | William Eric Shrader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194784264 PECOS PAC ID: 3779563515 Enrollment ID: I20040722000827 |
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