Provider Demographics
NPI:1093887648
Name:STRAUCH, ROBERT SALADE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SALADE
Last Name:STRAUCH
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:PO BOX 1967
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25402
Mailing Address - Country:US
Mailing Address - Phone:304-267-6119
Mailing Address - Fax:304-264-9105
Practice Address - Street 1:2000 PROFESSIONAL COURT
Practice Address - Street 2:SUITE A
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401
Practice Address - Country:US
Practice Address - Phone:304-267-6119
Practice Address - Fax:304-264-9105
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11195208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0129353000Medicaid
WV0129353000Medicaid