Provider Demographics
NPI:1518925940
Name:SCHROEDER, WILLIAM MICHAEL (DC, MBA)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:DC, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 UNION AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-3247
Mailing Address - Country:US
Mailing Address - Phone:814-515-4083
Mailing Address - Fax:814-946-0700
Practice Address - Street 1:217 UNION AVE FL 2
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-3247
Practice Address - Country:US
Practice Address - Phone:814-515-4083
Practice Address - Fax:814-946-0700
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001334146OtherHIGHMARK GROUP NUMBER
PA871077OtherHIGHMARK INDVIDUAL
PA204938OtherUPMC PROVIDER NUMBER
PA0015856630004Medicaid
PA871077Medicare PIN
PA0015856630004Medicaid