=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487645743
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL FOSTER STROUP MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2005
-----------------------------------------------------
Last Update Date | 04/10/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 241 CHURCH ST
-----------------------------------------------------
City | HAYESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28904-9688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-389-6383
-----------------------------------------------------
Fax | 828-389-2322
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1309
-----------------------------------------------------
City | HAYESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28904-1309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-389-6383
-----------------------------------------------------
Fax | 828-389-2322
-----------------------------------------------------
=====================================================
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 | 26381
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------