Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 10884 | NH |
N | 2080N0001X | Neonatal-Perinatal Doctor | 0320000522 | VT |
NPI | 1639182660 |
---|---|
Provider Name | Dr. Ken A Schroeter |
First Address | Bedford, NH 03110-4619 |
Second Address | Bedford, NH 03110-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 20/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02623710 | (05) | NY |
1011154 | (05) | VT |
H12999 | (02) |