Provider Demographics
NPI:1568473320
Name:SCHREIBER, ROBERT J (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1705 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-3529
Mailing Address - Country:US
Mailing Address - Phone:931-388-2190
Mailing Address - Fax:931-388-2190
Practice Address - Street 1:1705 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3529
Practice Address - Country:US
Practice Address - Phone:931-388-2190
Practice Address - Fax:931-388-2190
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM168213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT61064Medicare UPIN
TN3350591Medicare ID - Type Unspecified