Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 21852 | KY |
NPI | 1013901040 |
---|---|
Provider Name | Julia Schroeder |
First Address | Louisville, KY 40245-5360 |
Second Address | Louisville, KY 40207-4847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 07/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100029610A | (05) | IN |
64218522 | (05) | KY |
E39162 | (02) | KY |