Healthcare Provider Details

I. General information

NPI: 1003158809
Provider Name (Legal Business Name): MICHELLE NICOLE SCHROEDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 3RD ST
GREENSBORO NC
27405-6967
US

IV. Provider business mailing address

1101 EXCHANGE PL APT 1022
DURHAM NC
27713-1895
US

V. Phone/Fax

Practice location:
  • Phone: 336-890-3200
  • Fax: 336-890-3290
Mailing address:
  • Phone: 716-465-3253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2020-01648
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2020-01648
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: