Provider Demographics
NPI:1346252491
Name:EICH, STEVEN E (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:EICH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MILAN RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-7800
Mailing Address - Country:US
Mailing Address - Phone:419-627-8878
Mailing Address - Fax:419-627-9677
Practice Address - Street 1:5500 MILAN RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-7800
Practice Address - Country:US
Practice Address - Phone:419-627-8878
Practice Address - Fax:419-627-9677
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3286/T914152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
EI0518702Medicare ID - Type Unspecified
T47631Medicare UPIN