Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 57439-20 | WI |
N | 207L00000X | Anesthesiologist | MD60223818 | WA |
NPI | 1003019670 |
---|---|
Provider Name | Andrew Mark Schroeder |
First Address | Madison, WI 53711-2952 |
Second Address | Madison, WI 53711-2952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 06/12/2017 |