Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 5101011348 | MI |
NPI | 1174634372 |
---|---|
Provider Name | Steven Strbich |
First Address | Fountain Valley, CA 92728-8309 |
Second Address | Ludington, MI 49431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 31/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G14616 | (02) |