Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 20040840A | IN |
N | 103T00000X | Psychologist | 20040840A | IN |
Y | 103G00000X | Clinical Psychologist | 20040840A | IN |
Y | 103TC0700X | Clinical Psychologist | 20040840A | IN |
NPI | 1003910480 |
---|---|
Provider Name | Dr. David Frederick Strus |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Kokomo, IN 46901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 26/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000343505 | ANTHEM BX/BS ID NUMBER (01) | IN |
6127954 | UBH ID NUMBER (01) | IN |
96612 | CIGNA GM ID NUMBER (01) | IN |
STRUS-0002 | COMPCARE ID NUMBER (01) | IN |