MEDICARE: DR. MICHAEL S. SCHROEDER M.D.

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	207P00000X	Emergency Medicine Physician	40687	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00308116	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4119570	OTHER	TN	BLUE CROSS
3	4150087	OTHER	TN	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447294848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL S. SCHROEDER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 634706
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7565 DANNAHER WAY
Second Line	:
City	:	POWELL
State	:	TN
Zip	:	37849-4029
Country	:	US
Telephone Number	:	865-859-1060
Fax Number	:

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	11/30/2007

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