Healthcare Provider Details

I. General information

NPI: 1265700769
Provider Name (Legal Business Name): JEROME FRANK STRAUSS III M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 MONUMENT AVE APT 3
RICHMOND VA
23221-1737
US

IV. Provider business mailing address

805 E GRAVERS LN
WYNDMOOR PA
19038-7928
US

V. Phone/Fax

Practice location:
  • Phone: 804-254-4595
  • Fax:
Mailing address:
  • Phone: 215-233-2178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD018395E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: