Healthcare Provider Details

I. General information

NPI: 1487791745
Provider Name (Legal Business Name): ADAM STRUNK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3670 PARKER BLVD SUITE 101
PUEBLO CO
81008-2285
US

IV. Provider business mailing address

3670 PARKER BLVD SUITE 101
PUEBLO CO
81008-2285
US

V. Phone/Fax

Practice location:
  • Phone: 719-564-1544
  • Fax: 719-924-1593
Mailing address:
  • Phone: 719-564-1544
  • Fax: 719-924-1593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number51019
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number51019
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: