Basic Information
Provider Information
NPI: 1952316416
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRASBURGER
FirstName: VICTOR
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 933 BRADBURY DR SE
Address2: SUITE 2222
City: ALBUQUERQUE
State: NM
PostalCode: 871064374
CountryCode: US
TelephoneNumber: 5052723120
FaxNumber: 5052728060
Practice Location
Address1: DEPT PEDIATRICS 3RD FLOOR AMBULATORY CARE CTR
Address2: 2211 LOMAS BLVD. NE
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052720338
FaxNumber: 5052726845
Other Information
ProviderEnumerationDate: 07/30/2006
LastUpdateDate: 05/01/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080A0000X87-297NMY Allopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine

No ID Information.


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