Provider Demographics
NPI:1851369094
Name:STROUD, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:STROUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SANDWICH ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2183
Mailing Address - Country:US
Mailing Address - Phone:508-746-2000
Mailing Address - Fax:508-830-2502
Practice Address - Street 1:275 SANDWICH ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2183
Practice Address - Country:US
Practice Address - Phone:508-746-2000
Practice Address - Fax:508-830-2502
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42441207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00387846OtherRAILROAD MEDICARE
MA703299OtherTUFTS HEALTH PLAN
MAM09660OtherBCBSMA
MA000000033501OtherBMC HEALTHNET PLAN
MA2070049Medicaid
MAAA65389OtherHARVARD PILGRIM HEALTHCAR
MA000000033501OtherBMC HEALTHNET PLAN
B98714Medicare UPIN