Healthcare Provider Details

I. General information

NPI: 1962248047
Provider Name (Legal Business Name): DAVID WESLEY STRATTON CMD
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: DW STRATTON CMD

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LOCUST ST
NORTHAMPTON MA
01060-2093
US

IV. Provider business mailing address

409 MAIN RD
CHESTERFIELD MA
01012-9721
US

V. Phone/Fax

Practice location:
  • Phone: 413-582-2000
  • Fax:
Mailing address:
  • Phone: 269-635-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2002302
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: