MEDICARE: JOHN C. 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
1	2084P0800X	Psychiatry Physician	MD038967L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD038967-L	OTHER	PA	MEDICAL EXAMINERS LICENSE

General Provider Information

NPI Number	:	1770539652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C. SCHROEDER MD

Provider Business Mailing Address
First Line	:	5055 SWAMP RD # 553
Second Line	:
City	:	FOUNTAINVILLE
State	:	PA
Zip	:	18923-9643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 N GILBERT ST
Second Line	:	TINTON FALLS VA - CBOC, BLDG 4, STE 4101
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4955
Country	:	US
Telephone Number	:	732-842-4751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	08/03/2012

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