Healthcare Provider Details

I. General information

NPI: 1811037518
Provider Name (Legal Business Name): DONALD R STRANAHAN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 MARVEL CT
EASTON MD
21601-4053
US

IV. Provider business mailing address

13487 BLACKBERRY LANE
WYE MILLS MD
21679
US

V. Phone/Fax

Practice location:
  • Phone: 410-819-8867
  • Fax:
Mailing address:
  • Phone: 410-310-6205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0069987
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: