Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 65596-20 | WI |
N | 208600000X | Surgeon | 65596-20 | WI |
Y | 208200000X | Surgeon | MD181590 | OR |
Y | 208600000X | Surgeon | MD181590 | OR |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 15777 | NH |
NPI | 1083848972 |
---|---|
Provider Name | Dr. Andrea Margit Stroud |
First Address | Portland, OR 97239-4501 |
Second Address | Portland, OR 97239-4501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2009 |
Last Update Date | 09/03/2020 |