Provider Demographics
NPI:1740450717
Name:WILLIAM D STRAUCH MD
Entity type:Organization
Organization Name:WILLIAM D STRAUCH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:STRAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-232-0510
Mailing Address - Street 1:96 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3235
Mailing Address - Country:US
Mailing Address - Phone:304-232-0510
Mailing Address - Fax:304-232-0526
Practice Address - Street 1:96 12TH ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3235
Practice Address - Country:US
Practice Address - Phone:304-232-0510
Practice Address - Fax:304-232-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11196332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0096642000Medicaid
WV1309840001Medicare NSC
WVA72054Medicare UPIN