MEDICARE: KEVIN R. SCHROEDER, DPM

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	213ES0131X	Foot Surgery Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912950171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN R. SCHROEDER, DPM

Provider Business Mailing Address
First Line	:	3121 EVELYN DR
Second Line	:	STE 120
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-4309
Country	:	US
Telephone Number	:	937-427-1175
Fax Number	:	937-427-9494

Provider Business Practice Location Address
First Line	:	3121 EVELYN DR
Second Line	:	STE 120
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-4309
Country	:	US
Telephone Number	:	937-427-1175
Fax Number	:	937-427-9494

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN RAYMOND SCHROEDER
Credential	:	D.P.M.
Telephone Number	:	937-427-1175

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	03/10/2009

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