Eddy, Stephen Derrick

Eddy, Stephen Derrick is an individual health care provider with primary practice located at 30 Medical Park Suite 201, Wheeling WV 26003-6391. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Eddy, Stephen Derrick can be contacted via phone (304) 243-8630.

Contact Information

Primary practice address
30 Medical Park Suite 201 Wheeling WV 26003-6391
Phone: (304) 243-8630
Fax: (304) 243-8575
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X 35084571 Ohio
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X PA MD429317 Pennsylvania

Profile Details

NPI number 1255351201
LBN Legal business name Eddy, Stephen Derrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Oct 9th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255351201 NPPES
Pennsylvania Other P00469047 RR MEDICARE
Pennsylvania MEDICAID 0018294730001 RR MEDICARE
Pennsylvania MEDICAID 2679632 RR MEDICARE
Pennsylvania MEDICAID 3810006366 RR MEDICARE
Pennsylvania Other P00428195 RR MEDICARE

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