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General NPI Number Information
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NPI Number | 1376504365
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Entity Type | Individual
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Provider Name | SUE A STRAYER MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 E LAKE SHORE DRIVE ST MARYS-DECATUR
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City | DECATUR
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State | IL
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Zip | 62521-3883
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Country | US
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Telephone | 217-464-2966
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Fax | 217-464-3193
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Provider Business Mailing Address
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Address Line | PO BOX 790129
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City | ST LOUIS
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State | MO
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Zip | 63179-0129
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Country | US
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Telephone | 217-964-2966
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Fax | 217-464-3193
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | IL
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