MEDICARE: DR. NED RICHARD SCHROEDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	WA0021484	WA
2	207X00000X	Orthopaedic Surgery Physician	M-3825	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000010005940	OTHER	ID	REGENCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063407682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NED RICHARD SCHROEDER MD

Provider Business Mailing Address
First Line	:	3431 16TH ST
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-5630
Country	:	US
Telephone Number	:	208-743-7617
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 WARNER DR
Second Line	:
City	:	LEWISTON
State	:	ID
Zip	:	83501-4441
Country	:	US
Telephone Number	:	208-743-3523
Fax Number	:	208-746-8741

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/08/2007

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