Provider Demographics
NPI:1083693154
Name:SCHREEDER, MARSHALL T (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:T
Last Name:SCHREEDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18428
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8428
Mailing Address - Country:US
Mailing Address - Phone:256-705-4224
Mailing Address - Fax:256-705-4135
Practice Address - Street 1:3601 CCI DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-2606
Practice Address - Country:US
Practice Address - Phone:256-705-4224
Practice Address - Fax:256-705-4135
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9089207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL110031747OtherRR MEDICARE
AL000013036Medicaid
ALCA0084OtherRR MEDICARE
51013036OtherBLUE CROSS OF ALABAMA
AL528701110Medicaid
AL510-50070OtherBCBS OF ALABAMA
C74041Medicare UPIN
AL528701110Medicaid
ALCA0084OtherRR MEDICARE
E359Medicare PIN