Healthcare Provider Details

I. General information

NPI: 1174916878
Provider Name (Legal Business Name): JOSHUA SAMUEL STRAIT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 MDG UNIT 3215
RAMSTEIN AB APO AE
09094
DE

IV. Provider business mailing address

86 MDG UNIT 325
RAMSTEIN AB APO AE
09094
DE

V. Phone/Fax

Practice location:
  • Phone: 314-479-2609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number02005579A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number02005579A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: