MEDICARE: SARA B. SCHRADER 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	207P00000X	Emergency Medicine Physician	28505	KY
2	207P00000X	Emergency Medicine Physician	10788	MS
3	207Q00000X	Family Medicine Physician	10788	MS

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932157013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA B. SCHRADER MD

Provider Business Mailing Address
First Line	:	227 BELLEWETHER PASS
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-8758
Country	:	US
Telephone Number	:	601-605-0459
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 HIGHWAY 61 N
Second Line	:
City	:	TUNICA
State	:	MS
Zip	:	38676-9683
Country	:	US
Telephone Number	:	662-357-0012
Fax Number	:	662-357-0021

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/01/2009

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Directions to “ SARA B. SCHRADER MD” Practice Location

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