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General NPI Number Information
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NPI Number | 1134422389
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Entity Type | Organization
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Legal Business Name | MARK E. SCHROEDER M.D.PA
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 1005 COLLEGE BLVD W SUITE C
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City | NICEVILLE
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State | FL
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Zip | 32578-1053
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Country | US
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Telephone | 850-678-3994
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 COLLEGE BLVD W SUITE C
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City | NICEVILLE
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State | FL
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Zip | 32578-1053
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Country | US
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Telephone | 850-678-3994
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Fax | 850-678-7131
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK E SCHROEDER
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Credential | 8506783994
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Telephone | 850-678-3994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME69073
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License Number State | FL
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