MEDICARE: DR. MICHAEL WARREN STROUD PHD

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	103TH0004X	Health Psychologist	3421	CO

General Provider Information

NPI Number	:	1831418789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL WARREN STROUD PHD

Provider Business Mailing Address
First Line	:	1055 CLERMONT ST
Second Line	:	116B DENVER VA MEDICAL CENTER
City	:	DENVER
State	:	CO
Zip	:	80220-3808
Country	:	US
Telephone Number	:	303-399-8020
Fax Number	:	303-393-5076

Provider Business Practice Location Address
First Line	:	1055 CLERMONT ST.
Second Line	:	116B DENVER VA MEDICAL CENTER
City	:	DENVER
State	:	CO
Zip	:	80220-3808
Country	:	US
Telephone Number	:	303-399-8020
Fax Number	:	303-393-5076

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

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	05/18/2010

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