1205805181 NPI number — DISTRICT HEALTH DEPARTMENT NO. 2

Table of content: DR. MARTIN J SCHROEDER MD (NPI 1407899933)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205805181 NPI number — DISTRICT HEALTH DEPARTMENT NO. 2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DISTRICT HEALTH DEPARTMENT NO. 2
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205805181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
630 PROGRESS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST BRANCH
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48661-8603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-345-5020
Provider Business Mailing Address Fax Number:
989-343-1899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 PROGRESS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST BRANCH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48661-8603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-345-5020
Provider Business Practice Location Address Fax Number:
989-343-1899
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BENJAMIN
Authorized Official First Name:
LYNNETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
HEALTH OFFICER
Authorized Official Telephone Number:
989-343-1800

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  0000009 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4318627 . This is a "MOLINA FAMILY PLANNING" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4318627 . This is a "MCLAREN - FP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 232675845 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 235101220 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 235101258 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5008766930 . This is a "BCBS FP/WHC/IMMS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 235101267 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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