Provider Demographics
NPI:1467598185
Name:STRAUB, DONALD RICHARD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:RICHARD
Last Name:STRAUB
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8262 ATLEE RD
Mailing Address - Street 2:MOB III SUITE 205
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1816
Mailing Address - Country:US
Mailing Address - Phone:804-559-0194
Mailing Address - Fax:804-559-0198
Practice Address - Street 1:8262 ATLEE RD
Practice Address - Street 2:MOB III SUITE 205
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1816
Practice Address - Country:US
Practice Address - Phone:804-559-0194
Practice Address - Fax:804-559-0198
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13000363AS0400X
VA0110840626363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN
VAC06115OtherGROUP PTAN
VAC06695OtherGROUP PTAN