Basic Information
| Provider Information | |||||||||
| NPI: | 1467410068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRUB | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1331 N ELM ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274016302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362749617 | ||||||||
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| Practice Location | |||||||||
| Address1: | 234 GOODMAN ST | ||||||||
| Address2: | ML 761 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452671000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135842146 | ||||||||
| FaxNumber: | 5135840431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 06/24/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 35081764 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085R0202X | 35081764 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.