Basic Information
Provider Information
NPI: 1932328143
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STROBEL
FirstName: TERRI
MiddleName: S
NamePrefix: MS.
NameSuffix:  
Credential: P.A.-C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 610 SOLAREX CT
Address2:  
City: FREDERICK
State: MD
PostalCode: 217038624
CountryCode: US
TelephoneNumber: 3016636162
FaxNumber:  
Practice Location
Address1: 10200 COPPERMINE RD
Address2:  
City: WOODSBORO
State: MD
PostalCode: 217988319
CountryCode: US
TelephoneNumber: 3018980618
FaxNumber: 3018457939
Other Information
ProviderEnumerationDate: 04/25/2007
LastUpdateDate: 07/26/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XC0001474MDY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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