Healthcare Provider Details

I. General information

NPI: 1346860467
Provider Name (Legal Business Name): VICTOR CRAIG STRASBURG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MAC LN
PIERRE SD
57501-3391
US

IV. Provider business mailing address

100 MAC LN
PIERRE SD
57501-3391
US

V. Phone/Fax

Practice location:
  • Phone: 605-224-5901
  • Fax:
Mailing address:
  • Phone: 701-720-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14591
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: