Provider Demographics
NPI:1699113183
Name:STROMQUIST, EMILY R (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:R
Last Name:STROMQUIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CENTER ST
Mailing Address - Street 2:CWEB 100
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-3301
Mailing Address - Country:US
Mailing Address - Phone:251-415-8602
Mailing Address - Fax:251-415-1552
Practice Address - Street 1:1300 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5103
Practice Address - Country:US
Practice Address - Phone:218-333-5289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.34100207V00000X
390200000X
MN61893207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program