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NPI Code Detail

MEDICARE: DR. SONYA BOSSER SCHROEDER MD

MEDICARE: DR. SONYA BOSSER SCHROEDER MD
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
12084P0800XPsychiatry Physician49610MN

General Provider Information

NPI Number : 1225117377
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SONYA BOSSER SCHROEDER MD
Provider Business Mailing Address
First Line : 1900 SILVER LAKE RD NW
Second Line : SUITE 110
City : NEW BRIGHTON
State : MN
Zip : 55112-1786
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11010 PRAIRIE LAKES DR STE 350
Second Line : PRAIRIE LAKES CORPORATE CENTER II
City : EDEN PRAIRIE
State : MN
Zip : 55344-3801
Country : US
Telephone Number : 952-746-2522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 09/24/2012

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