Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 36766 | SC |
N | 208000000X | Pediatrician | 390200000X | MN |
Y | 2080P0203X | Pediatric Critical Care Doctor | 36766 | SC |
NPI | 1295028397 |
---|---|
Provider Name | Luke William Schroeder |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2011 |
Last Update Date | 26/06/2018 |