MEDICARE: DR. JODIE L STRAUSS DO

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	174400000X	Specialist	OS010689L	PA
2	207R00000X	Internal Medicine Physician	34.010979	OH

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

General Provider Information

NPI Number	:	1669447611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODIE L STRAUSS DO

Provider Business Mailing Address
First Line	:	PO BOX 772040
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48277-2040
Country	:	US
Telephone Number	:	800-589-6006
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 S GREEN RD STE 260
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-4192
Country	:	US
Telephone Number	:	216-381-6177
Fax Number	:

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	10/21/2021

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