Healthcare Provider Details

I. General information

NPI: 1275623175
Provider Name (Legal Business Name): ROBERT GEORGE STRANGE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIR HEART AND VASCULAR CENTER
PORTSMOUTH VA
23708-2111
US

IV. Provider business mailing address

306 FOUNDERS POINTE TRL
CARROLLTON VA
23314-2738
US

V. Phone/Fax

Practice location:
  • Phone: 757-238-2989
  • Fax: 757-953-2418
Mailing address:
  • Phone: 757-238-9882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD-066612-L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD-066612-L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberLL27201
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number0101242312
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: