Provider Demographics
NPI:1164403945
Name:STROHECKER, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:STROHECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 402145
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2145
Mailing Address - Country:US
Mailing Address - Phone:803-799-3737
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:2739 LAUREL ST
Practice Address - Street 2:SUITE 1-A
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2028
Practice Address - Country:US
Practice Address - Phone:803-799-4800
Practice Address - Fax:803-256-0395
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9524207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC95248Medicaid
SC4000Medicare PIN
SC95248Medicaid
SCD99183Medicare UPIN
SCAA8641A890Medicare PIN