Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | DPM168 | TN |
NPI | 1568473320 |
---|---|
Provider Name | Dr. Robert J Schreiber |
First Address | Columbia, TN 38401-3529 |
Second Address | Columbia, TN 38401-3529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T61064 | (02) | TN |