Basic Information
| Provider Information | |||||||||
| NPI: | 1407050461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRITTMATTER | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | GALLMANN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8230 SUMMA AVE STE C | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708093421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257570552 | ||||||||
| FaxNumber: | 2257639997 | ||||||||
| Practice Location | |||||||||
| Address1: | 9050 AIRLINE HWY | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708154103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2259248267 | ||||||||
| FaxNumber: | 2259248242 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 06/26/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2085R0202X | M6898 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | BP1-0026384 | 01 | INSTITUTIONAL PERMIT | OTHER |