Provider Demographics
NPI:1962469262
Name:STRICKLAND, MAURICE HENRY VAN (MD)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:HENRY VAN
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10021 W 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1831
Mailing Address - Country:US
Mailing Address - Phone:316-722-4800
Mailing Address - Fax:316-722-5117
Practice Address - Street 1:10021 W 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1831
Practice Address - Country:US
Practice Address - Phone:316-722-4800
Practice Address - Fax:316-722-5117
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-18175207KI0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSE10205Medicare UPIN
KS110744Medicare ID - Type Unspecified