MEDICARE: DR. CARL ERNEST SHRADER JR. 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	207Q00000X	Family Medicine Physician	4602	AZ

General Provider Information

NPI Number	:	1912985110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL ERNEST SHRADER JR. MD

Provider Business Mailing Address
First Line	:	120 W. FINE AVE.
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001
Country	:	US
Telephone Number	:	928-773-9695
Fax Number	:	928-773-0208

Provider Business Practice Location Address
First Line	:	120 W. FINE AVE.
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001
Country	:	US
Telephone Number	:	928-773-9695
Fax Number	:	928-773-0208

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	12/21/2025

Similar Medicare Providers

1861357931 — RYAN KRUSE LAC
Practice Location Address:

914 N SAN FRANCISCO ST
FLAGSTAFF, AZ
86001-3254

Practice Phone: 623-695-7980
Practice Fax:

1952298770 — NICOLETTE E DRAGONY-GOFF APRN
Practice Location Address:

1895 N JASPER DR STE 3
FLAGSTAFF, AZ
86001-1632

Practice Phone: 928-913-8800
Practice Fax:

1598628240 — LAUREL CAPLAN
Practice Location Address:

813 W UNIVERSITY AVE APT 405
FLAGSTAFF, AZ
86001-7107

Practice Phone: 781-752-9120
Practice Fax:

1376930669 — VALERIE VAN RAVENSWAAY D.O.
Practice Location Address:

1200 N BEAVER ST
FLAGSTAFF, AZ
86001

Practice Phone: 928-214-2920
Practice Fax: 928-214-2925

1366075814 — DANIELLE DOMINIQUE KELLER PA-C
Practice Location Address:

1330 N RIM DR STE A
FLAGSTAFF, AZ
86001-3138

Practice Phone: 661-843-6420
Practice Fax:

1457173312 — NAZ MUA LLC
Practice Location Address:

1501 S YALE ST STE 250
FLAGSTAFF, AZ
86001-7336

Practice Phone: 928-556-0707
Practice Fax: 928-250-5337

Directions to “ DR. CARL ERNEST SHRADER JR. MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.