Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 03783 | MD |
NPI | 1003808254 |
---|---|
Provider Name | Dr. Albert John Strauss JR. |
First Address | Hagerstown, MD 21740 |
Second Address | Hagerstown, MD 21740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 12/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006541200 | (05) | MD |
078180 | (02) |