Healthcare Provider Details

I. General information

NPI: 1104854686
Provider Name (Legal Business Name): BRADY J SCHROER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N JUSTICE ST
HENDERSONVILLE NC
28791-3410
US

IV. Provider business mailing address

171 JOE BAILEY DR
FLETCHER NC
28732-9105
US

V. Phone/Fax

Practice location:
  • Phone: 828-696-4250
  • Fax: 828-696-4256
Mailing address:
  • Phone: 828-696-4250
  • Fax: 828-696-4256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2007-01393
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: