Provider Demographics
NPI:1215939608
Name:STREHLOW, MARK DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:DAVID
Last Name:STREHLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 COLLEGE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1617
Mailing Address - Country:US
Mailing Address - Phone:913-727-7700
Mailing Address - Fax:
Practice Address - Street 1:5401 COLLEGE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1617
Practice Address - Country:US
Practice Address - Phone:913-727-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21629207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
13834037OtherBCBS OF KC
100544OtherBCBS OF KS
100544Medicare ID - Type Unspecified
B91264Medicare UPIN