Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD-066612-L | PA |
N | 208600000X | Surgeon | MD-066612-L | PA |
N | 2086S0102X | Surgical Critical Care | MD-066612-L | PA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101242312 | VA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | LL27201 | SC |
NPI | 1275623175 |
---|---|
Provider Name | Dr. Robert George Strange JR. |
First Address | Carrollton, VA 23314-2738 |
Second Address | Portsmouth, VA 23708-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 23/11/2021 |