Healthcare Provider Details

I. General information

NPI: 1457356420
Provider Name (Legal Business Name): CHRISTOPHER W SCHROEDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721-07 EBENEZER ROAD SUITE 175
ROCK HILL SC
29732
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-5256
  • Fax: 803-328-0440
Mailing address:
  • Phone: 704-384-7840
  • Fax: 704-384-7830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number13444
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number23262
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: