Provider Demographics
NPI:1093813180
Name:STROCEL, ANTON (MD)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:
Last Name:STROCEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5004
Mailing Address - Country:US
Mailing Address - Phone:810-767-3220
Mailing Address - Fax:810-767-7969
Practice Address - Street 1:1402 W COURT ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5004
Practice Address - Country:US
Practice Address - Phone:810-767-3220
Practice Address - Fax:810-767-7969
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301034480207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB44214Medicare UPIN