Provider Demographics
NPI:1922119304
Name:ELERDING, STEVEN CURTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CURTIS
Last Name:ELERDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-2240
Mailing Address - Country:US
Mailing Address - Phone:509-837-7722
Mailing Address - Fax:509-837-2587
Practice Address - Street 1:500 S 11TH ST
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-2240
Practice Address - Country:US
Practice Address - Phone:509-837-7722
Practice Address - Fax:509-837-2587
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18116208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG115120700OtherMEDICARE PIN
WA1646801Medicaid
WA1646801Medicaid
WAG000119092Medicare PIN