Provider Demographics
NPI:1457331019
Name:STRITZKE, DONALD K (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:K
Last Name:STRITZKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-454-9181
Mailing Address - Fax:208-454-6338
Practice Address - Street 1:1620 S KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4547
Practice Address - Country:US
Practice Address - Phone:208-454-9181
Practice Address - Fax:208-454-6338
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM5778208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID20000896Medicare PIN