Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 14366 | AL |
NPI | 1457488025 |
---|---|
Provider Name | Harry W. Schroeder JR. |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35294-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 29/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051592515 | BCBS (01) | AL |
051592516 | BCBS (01) | AL |
051592520 | BCBS (01) | AL |
051592523 | BCBS (01) | AL |
103245 | (05) | AL |
103247 | (05) | AL |
103248 | (05) | AL |
103249 | (05) | AL |
F36123 | (02) | AL |
P00839375 | RAILROAD MEDICARE (01) | AL |