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Individual

DIANE STRAUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
860 POTOMAC CIR, AURORA, CO 80011-6714
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
DR.0066038
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
265177700
DC
01
51548
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/10/2006
Last updated
08/12/2021
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