1427070838 NPI number — STEVEN D STRAUSBAUGH MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427070838 NPI number — STEVEN D STRAUSBAUGH MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

STRAUSBAUGH

Provider First Name:

STEVEN

Provider Middle Name:

D

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1427070838

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/01/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

890 W MAIN ST STE 201

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

GENEVA

Provider Business Mailing Address State Name:

OH

Provider Business Mailing Address Postal Code:

44041-1237

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

440-593-0197

Provider Business Mailing Address Fax Number:

216-201-7892

Provider First Line Business Practice Location Address:

840 W MAIN ST SUITE 201

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

GENEVA

Provider Business Practice Location Address State Name:

OH

Provider Business Practice Location Address Postal Code:

44041

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

440-593-0197

Provider Business Practice Location Address Fax Number:

216-201-7892

Provider Enumeration Date:

07/24/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207RP1001X , with the licence number:  35078306 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2080P0214X , with the licence number: 35-078306 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1018439940001 . This is a "PA MEDICAID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2429992 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 000000388400 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 2429992 . This is a "BCMH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 000000221307 . This is a "UNISON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 364057 . This is a "WELLCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 000000526135 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 1427070838 . This is a "MI MEDICAID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 3810011487 . This is a "WV MEDICAID" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
• Identifier: 744996 . This is a "BUCKEYE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 7264465 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".