Basic Information
| Provider Information | |||||||||
| NPI: | 1407816507 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRATHERN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 262 | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296220262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645121440 | ||||||||
| FaxNumber: | 8645122379 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 E GREENVILLE ST | ||||||||
| Address2: | SUITE 2500 | ||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296211580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642241111 | ||||||||
| FaxNumber: | 8642241109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 01/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 29255 | SC | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | P01586222 | 01 | SC | RR MEDICARE | OTHER | PC1280 | 05 | SC | MEDICAID |