Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 0101052156 | VA |
NPI | 1043214315 |
---|---|
Provider Name | Scott Andrew Strelow |
First Address | Roanoke, VA 24008-1789 |
Second Address | Roanoke, VA 24014-1310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 04/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006307230 | (05) | VA |
G07304 | (02) | VA |