Provider Demographics
NPI:1902949720
Name:STROTHER, ERIC THURMOND (LCSA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:THURMOND
Last Name:STROTHER
Suffix:
Gender:M
Credentials:LCSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 BRECHIN DR
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-6261
Mailing Address - Country:US
Mailing Address - Phone:240-383-0436
Mailing Address - Fax:301-782-7902
Practice Address - Street 1:6305 BRECHIN DR
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-6261
Practice Address - Country:US
Practice Address - Phone:240-383-0436
Practice Address - Fax:301-782-7902
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSA0001246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant