Healthcare Provider Details

I. General information

NPI: 1053550152
Provider Name (Legal Business Name): CHRISTOPHER B STROUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2009
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 E DUPONT RD STE 105
FORT WAYNE IN
46825-0045
US

IV. Provider business mailing address

2512 E DUPONT RD STE 105
FORT WAYNE IN
46825-0045
US

V. Phone/Fax

Practice location:
  • Phone: 260-222-7401
  • Fax: 260-209-5956
Mailing address:
  • Phone: 260-222-7401
  • Fax: 260-209-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36754-020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01062792A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: