Provider Demographics
NPI:1477970051
Name:STRAUB, MICHAEL (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:STRAUB
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 ROUTE 51 STE 105
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3652
Mailing Address - Country:US
Mailing Address - Phone:412-775-2019
Mailing Address - Fax:127-775-2243
Practice Address - Street 1:1633 ROUTE 51 STE 105
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3652
Practice Address - Country:US
Practice Address - Phone:412-775-2019
Practice Address - Fax:127-775-2243
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013572363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner