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General NPI Number Information
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NPI Number | 1780798520
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Entity Type | Individual
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Provider Name | STEPHAN F STRASSER MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 748 S FLETCHER AVE
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-2230
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Country | US
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Telephone | 904-432-8205
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Fax |
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Provider Business Mailing Address
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Address Line | 748 S FLETCHER AVE
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-2230
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Country | US
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Telephone | 904-432-8205
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036067352
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME103634
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License Number State | FL
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