MEDICARE: DR. DONALD ALFRED STRANDBERG M.D.

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
1	207RI0200X	Infectious Disease Physician	26563	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0931691	OTHER	CO	AETNA
3	36604	OTHER	CO	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1508865544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD ALFRED STRANDBERG M.D.

Provider Business Mailing Address
First Line	:	3230 E WOODMEN RD
Second Line	:	SUITE 210
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920
Country	:	US
Telephone Number	:	719-578-5176
Fax Number	:	719-578-5188

Provider Business Practice Location Address
First Line	:	3230 E WOODMEN RD
Second Line	:	SUITE 210
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920
Country	:	US
Telephone Number	:	719-578-5176
Fax Number	:	719-578-5188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	10/10/2007

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