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NPI Code Detail

MEDICARE: MARK A. STRANGE HS, USCG

MEDICARE:   MARK A. STRANGE  HS, USCG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11710I1002XIndependent Duty Corpsman

General Provider Information

NPI Number : 1144406265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A. STRANGE HS, USCG
Provider Business Mailing Address
First Line : 1222 SPRUCE ST
Second Line : ROOM 2-102A
City : SAINT LOUIS
State : MO
Zip : 63103-2818
Country : US
Telephone Number : 314-269-2312
Fax Number : 314-269-2748
Provider Business Practice Location Address
First Line : 1222 SPRUCE ST
Second Line : ROOM 2-102A
City : SAINT LOUIS
State : MO
Zip : 63103-2818
Country : US
Telephone Number : 314-269-2312
Fax Number : 314-269-2748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2008
Last Update Date : 01/18/2008

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Directions to “ MARK A. STRANGE HS, USCG” Practice Location

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