MEDICARE: CLAYTON SCHROEDER MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1073221974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAYTON SCHROEDER MD PC

Provider Business Mailing Address
First Line	:	11819 MIRACLE HILLS DR STE 105
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-4428
Country	:	US
Telephone Number	:	402-356-8601
Fax Number	:	402-819-0919

Provider Business Practice Location Address
First Line	:	11819 MIRACLE HILLS DR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-5308
Country	:	US
Telephone Number	:	402-650-6661
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	BRANDI ANDERSON
Credential	:
Telephone Number	:	402-356-8601

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	07/23/2024

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