Provider Demographics
NPI:1295397750
Name:CALEB SCHROEDER MD LLC
Entity Type:Organization
Organization Name:CALEB SCHROEDER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-834-2450
Mailing Address - Street 1:618 N DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5122
Mailing Address - Country:US
Mailing Address - Phone:402-834-2450
Mailing Address - Fax:402-834-2449
Practice Address - Street 1:618 N DENVER AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5122
Practice Address - Country:US
Practice Address - Phone:402-834-2450
Practice Address - Fax:402-834-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty