Provider Demographics
NPI:1760713861
Name:JOHN F. STRANDMARK MD PLLC
Entity Type:Organization
Organization Name:JOHN F. STRANDMARK MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:STRANDMARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-349-0700
Mailing Address - Street 1:2248 MOUNT HOPE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-2501
Mailing Address - Country:US
Mailing Address - Phone:517-349-0700
Mailing Address - Fax:517-349-0600
Practice Address - Street 1:2248 MOUNT HOPE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2501
Practice Address - Country:US
Practice Address - Phone:517-349-0700
Practice Address - Fax:517-349-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1103304521OtherBLUE CROSS
1103304521OtherBLUE CROSS