Healthcare Provider Details

I. General information

NPI: 1225355134
Provider Name (Legal Business Name): AMBER NICOLE STROUPE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2010
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BOILING SPRINGS RD
BOILING SPRINGS SC
29316-5304
US

IV. Provider business mailing address

300 E MCBEE AVE STE 401
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-599-0731
  • Fax: 864-599-0791
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ1027
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number51269
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number51269
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ1027
License Number StateTX

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierSCD0513365
Identifier TypeOTHER
Identifier StateSC
Identifier IssuerMEDICARE PIN
# 2
Identifier512699
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: