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NPI Code Detail

MEDICARE: DR. FREDERICK C SCHUBERT M.D.

MEDICARE: DR. FREDERICK C SCHUBERT 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
1207ZC0500XCytopathology PhysicianMD14061OR
2207ZP0105XClinical Pathology/Laboratory Medicine PhysicianMD14061OR

Other Identifiers

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

General Provider Information

NPI Number : 1477536514
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICK C SCHUBERT M.D.
Provider Business Mailing Address
First Line : 1700 E. 19TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058
Country : US
Telephone Number : 541-296-7760
Fax Number : 541-296-7619
Provider Business Practice Location Address
First Line : 1700 E 19TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3317
Country : US
Telephone Number : 541-296-7760
Fax Number : 541-296-7619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 11/19/2007

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