Provider Demographics
NPI:1285627836
Name:STROEBEL, PAUL P (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:P
Last Name:STROEBEL
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 1:236 COLD SPRING ROAD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001
Mailing Address - Country:US
Mailing Address - Phone:860-673-0882
Mailing Address - Fax:
Practice Address - Street 1:236 COLD SPRING ROAD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001
Practice Address - Country:US
Practice Address - Phone:860-673-0882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018142207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001181429Medicaid
060052203OtherRAILROAD MEDICARE
B37783Medicare UPIN
060052203OtherRAILROAD MEDICARE
CT018142OtherCONNECTICARE
060052203OtherRAILROAD MEDICARE
2083456OtherAETNA
CTHAS596OtherOXFORD
CT060001269Medicare ID - Type Unspecified
010018142CT01OtherANTHEM BCBS