Provider Demographics
NPI:1144740002
Name:STROPES, PATRICK DONALD (CPRM,CPRC,RCSS)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:DONALD
Last Name:STROPES
Suffix:
Gender:M
Credentials:CPRM,CPRC,RCSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50430 SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-5910
Mailing Address - Country:US
Mailing Address - Phone:734-589-7474
Mailing Address - Fax:
Practice Address - Street 1:50430 SCHOOL HOUSE RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-5910
Practice Address - Country:US
Practice Address - Phone:734-589-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
M-00090175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI213119549Medicaid
MI1851448146OtherGROWTH WORKS INC