Provider Demographics
NPI:1104854686
Name:SCHROER, BRADY J (DO)
Entity Type:Individual
Prefix:DR
First Name:BRADY
Middle Name:J
Last Name:SCHROER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:171 JOE BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-9105
Mailing Address - Country:US
Mailing Address - Phone:828-696-4250
Mailing Address - Fax:828-696-4256
Practice Address - Street 1:800 N JUSTICE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3410
Practice Address - Country:US
Practice Address - Phone:828-696-4250
Practice Address - Fax:828-696-4256
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-013932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100420360BMedicaid
101993Medicare ID - Type Unspecified
KS100420360BMedicaid