Stephen Blackstone Edstrom in Wright Patterson Afb - Family Medicine
Stephen Blackstone Edstrom - NPI 1396942264
Stephen Blackstone Edstrom is a Family Medicine in Wright Patterson Afb, Ohio. Stephen Blackstone Edstrom practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Stephen Blackstone Edstrom is 1396942264. The last update date is 2023-03-01.
Stephen Blackstone Edstrom's current location address is 4481 Sugar Maple Dr, Wright Patterson Afb, Ohio. You can contact this provider via phone number 9372570837. The mailing address for Stephen Blackstone Edstrom is 4481 Sugar Maple Dr, Wright Patterson Afb, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen Blackstone Edstrom |
|---|---|
| Address | 4481 Sugar Maple Dr, Wright Patterson Afb, Ohio |
| Phone Number | 9372570837 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1396942264 |
|---|---|
| Provider Enumeration Date | 2007-07-02 |
| Last Updated Date | 2023-03-01 |
Provider Mailing Address Detail
| Address | 4481 Sugar Maple Dr |
|---|---|
| City | Wright Patterson Afb |
| State | Ohio (OH) |
| Post Code | 454335536 |
| Phone Number | 9372570837 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 01066091A |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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What is the unique identifier code issued to Stephen Blackstone Edstrom by the Centers for Medicare & Medicaid Services?
The Stephen Blackstone Edstrom has been assigned the NPI (National Provider Identifier) 1396942264. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Stephen Blackstone Edstrom?
The Stephen Blackstone Edstrom is situated at 4481 Sugar Maple Dr, in the city of Wright Patterson Afb, state of OH, with the zip code 454335536.
What is Stephen Blackstone Edstrom's specialized field of practice, and what is the corresponding taxonomy classification code?
The Stephen Blackstone Edstrom's area of specialization is Family Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Q00000X.
When did the Stephen Blackstone Edstrom receive its 1396942264?
The Stephen Blackstone Edstrom was issued its 1396942264 on 2007-07-02, which is the date when the organization was assigned this unique identifier.
As of what date were the details related to Stephen Blackstone Edstrom most recently updated or revised?
The information pertaining to Stephen Blackstone Edstrom, including its address, specialty, and other relevant details, was last updated or revised on 2023-03-01.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC