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General NPI Number Information
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NPI Number | 1275840902
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Entity Type | Organization
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Legal Business Name | CHARLES C STROUD MD PC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 4550 INVESTMENT DRIVE SUITE 240
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City | TROY
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State | MI
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Zip | 48098
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Country | US
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Telephone | 248-792-9881
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Fax | 248-792-9895
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Provider Business Mailing Address
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Address Line | 4550 INVESTMENT DR SUITE 240
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City | TROY
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State | MI
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Zip | 48098-6363
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Country | US
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Telephone | 248-792-9881
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Fax | 248-792-9895
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. CHARLES CHRISTOPHER STROUD
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Credential |
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Telephone | 248-792-9881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301059510
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License Number State | MI
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