Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 65326 | MN |
NPI | 1427493485 |
---|---|
Provider Name | Ronald J Schroeder II |
First Address | Woodbury, MN 55125-2524 |
Second Address | Woodbury, MN 55125-2529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2013 |
Last Update Date | 14/06/2019 |