Provider Demographics
NPI:1538181748
Name:STROHM, MAUREEN (MD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:STROHM
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 1:3371 N BUFFALO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129
Mailing Address - Country:US
Mailing Address - Phone:702-786-4268
Mailing Address - Fax:
Practice Address - Street 1:3371 N BUFFALO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129
Practice Address - Country:US
Practice Address - Phone:702-786-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16723207Q00000X
CAG40142207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ315349Medicaid
CAG40142OtherCALIF MEDICAL LICENSE
CA00G401420Medicaid