Healthcare Provider Details

I. General information

NPI: 1831159292
Provider Name (Legal Business Name): MICHAEL W STRATEMEIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NICOLS ROAD HSC, L-4, ROOM 080
STONY BROOK NY
11794-8350
US

IV. Provider business mailing address

101 NICOLS ROAD HSC, L-4, ROOM 080
STONY BROOK NY
11794-8350
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-2478
  • Fax: 631-444-3919
Mailing address:
  • Phone: 631-444-2478
  • Fax: 631-444-2478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number219353
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: