Healthcare Provider Details

I. General information

NPI: 1619078383
Provider Name (Legal Business Name): REBECCA ANN SCHROEDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST VAMC (112C)
DURHAM NC
27705-3875
US

IV. Provider business mailing address

103 NUTTAL PL
CHAPEL HILL NC
27514-2035
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-6938
  • Fax:
Mailing address:
  • Phone: 919-969-9810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200100951
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: