Provider Demographics
NPI:1841306123
Name:ERAKER, STEPHEN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ANDREW
Last Name:ERAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 NE WYATT CT
Mailing Address - Street 2:BEND VA CLINIC, SUITE 201
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7678
Mailing Address - Country:US
Mailing Address - Phone:541-381-9110
Mailing Address - Fax:541-389-5459
Practice Address - Street 1:2115 NE WYATT CT
Practice Address - Street 2:BEND VA CLINIC, SUITE 201
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7678
Practice Address - Country:US
Practice Address - Phone:541-381-9110
Practice Address - Fax:541-389-5459
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine