Healthcare Provider Details
I. General information
NPI: 1902013055
Provider Name (Legal Business Name): AMY CARSON-STRNAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/17/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 CHIEF EDDIE HOFFMAN HIGHWAY SUITE 3000
BETHEL AK
99559
US
IV. Provider business mailing address
23844 DEEGAN DR
HILL CITY SD
57745-6539
US
V. Phone/Fax
- Phone: 907-543-6300
- Fax:
- Phone: 605-574-2018
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4857 |
| License Number State | AK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: