Provider Demographics
NPI:1134106164
Name:STROBEL, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STROBEL
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 1:716 MAIDEN CHOICE LN
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-747-9422
Mailing Address - Fax:410-747-4871
Practice Address - Street 1:716 MAIDEN CHOICE LN
Practice Address - Street 2:SUITE 305
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-747-9422
Practice Address - Fax:410-747-4871
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD22877207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD37730190CMedicaid
MD8304Medicare ID - Type Unspecified
MD37730190CMedicaid