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General NPI Number Information
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NPI Number | 1295964682
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Entity Type | Individual
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Provider Name | PETER STROGOV M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 1359 OLD WATER WORKS RD SW
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City | FORT PAYNE
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State | AL
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Zip | 35968-3347
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Country | US
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Telephone | 256-997-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 1359 OLD WATERWORKS RD SW
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City | FORT PAYNE
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State | AL
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Zip | 35968-3347
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Country | US
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Telephone | 256-997-5900
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Fax | 256-997-5995
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 30426
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 30426
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License Number State | AL
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