Provider Demographics
NPI:1306858865
Name:CRIDER, STEVEN REID (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:REID
Last Name:CRIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:405 STELLA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2968
Mailing Address - Country:US
Mailing Address - Phone:318-807-8410
Mailing Address - Fax:318-807-8411
Practice Address - Street 1:405 STELLA ST
Practice Address - Street 2:SUITE A
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-2968
Practice Address - Country:US
Practice Address - Phone:318-807-8410
Practice Address - Fax:318-807-8411
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2009-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.14000R207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1100501Medicaid
A99792Medicare UPIN
LA4A295DD20Medicare PIN