Provider Demographics
NPI:1487685038
Name:STRAUSBAUGH, LARRY JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:JAMES
Last Name:STRAUSBAUGH
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3710 SW VETERANS HOSPITAL ROAD
Mailing Address - Street 2:PORTLAND VA MEDICAL CENTER (P-3-ID)
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-220-8262
Mailing Address - Fax:503-273-5348
Practice Address - Street 1:3710 SW VETERANS HOSPITAL ROAD
Practice Address - Street 2:PORTLAND VA MEDICAL CENTER (P-3-ID)
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:503-273-5348
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD14242207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
93874Medicare UPIN