Provider Demographics
NPI:1407816507
Name:STRATHERN, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:STRATHERN
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 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-6810
Mailing Address - Fax:864-224-1109
Practice Address - Street 1:2000 E GREENVILLE ST STE 2500
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1728
Practice Address - Country:US
Practice Address - Phone:864-512-6810
Practice Address - Fax:864-224-1109
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29255208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1280Medicaid
SCP01586222OtherRR MEDICARE
SCPC1280Medicaid
SCG79256Medicare UPIN