MEDICARE: JOHN PATRICK STRAETMANS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	036019	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036019	OTHER	GA	MMEDICAL LICENSE NO

General Provider Information

NPI Number	:	1134126733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PATRICK STRAETMANS MD

Provider Business Mailing Address
First Line	:	294 S MAIN ST
Second Line	:	STE 200
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-1969
Country	:	US
Telephone Number	:	770-754-5555
Fax Number	:	770-754-5511

Provider Business Practice Location Address
First Line	:	294 S MAIN ST
Second Line	:	STE 200
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-1969
Country	:	US
Telephone Number	:	770-754-5555
Fax Number	:	770-754-5511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	10/22/2015

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