Individual
SEAN PATRICK STROUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 N 2ND ST STE 103, BOISE, ID 83702-6081
(208) 381-4700
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(619) 532-7202
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A81753
CA
208800000X
Urology Physician
Primary
M-15955
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A81753
STATE
CA
01
—
MD448962
STATE
PA
Enumeration date
02/02/2006
Last updated
05/19/2022
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