Provider Demographics
NPI:1033259643
Name:SCHRADER, RHONDA K (OD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:K
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 EAST W.T. HARRIS BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4104
Mailing Address - Country:US
Mailing Address - Phone:704-549-4523
Mailing Address - Fax:704-549-0606
Practice Address - Street 1:1001 EAST W.T. HARRIS BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4104
Practice Address - Country:US
Practice Address - Phone:704-549-4523
Practice Address - Fax:704-549-0606
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1672152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093HUOtherBCBS
NC05415OtherSPECTERA
NCU75191Medicare UPIN
NC093HUOtherBCBS