Provider Demographics
NPI:1568585206
Name:STROH, ANN LOUISE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:LOUISE
Last Name:STROH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:STROH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:701 10TH ST SE HPCC 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1251
Mailing Address - Country:US
Mailing Address - Phone:319-363-8303
Mailing Address - Fax:319-364-4659
Practice Address - Street 1:701 10TH ST SE FL HPCC3
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1251
Practice Address - Country:US
Practice Address - Phone:319-363-8303
Practice Address - Fax:319-364-4659
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48170207RX0202X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01829874Medicaid
COP00944664OtherMEDICARE RAILROAD CARRIER PTAN
CO01829874Medicaid
COCO305727Medicare PIN
COCOA102145Medicare PIN