Provider Demographics
NPI:1609875012
Name:STRATMAN, TED R (DC)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:R
Last Name:STRATMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 SABATTUS ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5430
Mailing Address - Country:US
Mailing Address - Phone:207-376-3877
Mailing Address - Fax:207-786-8921
Practice Address - Street 1:416 SABATTUS ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5430
Practice Address - Country:US
Practice Address - Phone:207-777-3333
Practice Address - Fax:207-786-8921
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2024-01-24
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-05-01
Provider Licenses
StateLicense IDTaxonomies
NE1326111N00000X
MECR1358111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09061OtherBC HME
NE100 25 9818 00Medicaid
NE99534OtherBCBS
NE100 25 9818 00Medicaid
NE277346Medicare ID - Type UnspecifiedSOLO #
NE99534OtherBCBS