Provider Demographics
NPI:1407352008
Name:STROUD, ALYSSA JOY (MD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JOY
Last Name:STROUD
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 1:22250 PROVIDENCE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6210
Mailing Address - Country:US
Mailing Address - Phone:248-662-4333
Mailing Address - Fax:248-662-3022
Practice Address - Street 1:22250 PROVIDENCE DR STE 206
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6210
Practice Address - Country:US
Practice Address - Phone:248-662-4333
Practice Address - Fax:248-662-3022
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301510031208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty