Healthcare Provider Details

I. General information

NPI: 1447339809
Provider Name (Legal Business Name): JEFFREY DAVID SCHROEDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 MEMORIAL DR
TWO RIVERS WI
54241-3900
US

IV. Provider business mailing address

1035 KEPLER DR
GREEN BAY WI
54311-8320
US

V. Phone/Fax

Practice location:
  • Phone: 920-794-5125
  • Fax: 920-794-5465
Mailing address:
  • Phone: 920-490-9046
  • Fax: 490-405-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number48823-021
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number48823
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number48823
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number48823-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: