Provider Demographics
NPI:1306937792
Name:STRASBERGER, ROBERT A (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:STRASBERGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31961 OLDE FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1731
Mailing Address - Country:US
Mailing Address - Phone:248-895-7635
Mailing Address - Fax:248-865-7244
Practice Address - Street 1:31961 OLDE FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1731
Practice Address - Country:US
Practice Address - Phone:248-895-7635
Practice Address - Fax:248-865-7244
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001857213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4259105Medicaid
MIP00261128OtherRAILROAD
MIRS001857OtherBC
MIP00261128OtherRAILROAD
MIU72783Medicare UPIN