Healthcare Provider Details

I. General information

NPI: 1710911821
Provider Name (Legal Business Name): PAMELA R SCHROEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 33RD ST SUITE 551 / 33RD ST PROF OFF BLDG
BALTIMORE MD
21218-3322
US

IV. Provider business mailing address

200 E 33RD ST SUITE 551 / 33RD ST PROF OFF BLDG
BALTIMORE MD
21218-3322
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-4511
  • Fax:
Mailing address:
  • Phone: 410-554-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0064294
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: