=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053376137
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID STRASSLER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2006
-----------------------------------------------------
Last Update Date | 09/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 61 BARRA ROAD
-----------------------------------------------------
City | BIDDEFORD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04005-3243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-283-1441
-----------------------------------------------------
Fax | 207-523-1136
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 9746
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04104-5040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-828-2449
-----------------------------------------------------
Fax | 207-828-7850
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD11134
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------