Healthcare Provider Details
I. General information
NPI: 1316965387
Provider Name (Legal Business Name): STEVEN M STROM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3200 W KIMBERLY RD
DAVENPORT IA
52806-3059
US
IV. Provider business mailing address
3200 WEST KIMBERLY ROAD SUITE 200
DAVENPORT IA
52806
US
V. Phone/Fax
- Phone: 563-421-0220
- Fax: 563-421-4022
- Phone: 563-421-4400
- Fax: 563-421-4449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 3727 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: