Provider Demographics
NPI:1639164270
Name:STRAUS, JOHN SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SAMUEL
Last Name:STRAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:189 GOVERNOR ST 202
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3124
Mailing Address - Country:US
Mailing Address - Phone:401-455-1772
Mailing Address - Fax:401-455-1771
Practice Address - Street 1:534 ANGELL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4414
Practice Address - Country:US
Practice Address - Phone:401-490-2033
Practice Address - Fax:401-455-1771
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD10393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine