Provider Demographics
NPI:1780626598
Name:STROBL, FREDERICK THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:THOMAS
Last Name:STROBL
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 1:4225 GOLDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4215
Mailing Address - Country:US
Mailing Address - Phone:763-588-0661
Mailing Address - Fax:763-287-2310
Practice Address - Street 1:4225 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4215
Practice Address - Country:US
Practice Address - Phone:763-588-0661
Practice Address - Fax:763-287-2310
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN227112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN22800OtherAMERICA'S PPO
MN0265022OtherPREFERRED ONE
WI30478100Medicaid
MNHP14499OtherHEALTHPARTNERS
MN51478STOtherBCBS OF MN
MN0501970OtherMEDICA
MNHP14499OtherHEALTHPARTNERS