Provider Demographics
NPI:1649202060
Name:SCHROERING, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:SCHROERING
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 1:1322 LOCUST AVE
Mailing Address - Street 2:PO BOX 1112
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554
Mailing Address - Country:US
Mailing Address - Phone:304-366-0700
Mailing Address - Fax:304-366-9529
Practice Address - Street 1:1322 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-366-0700
Practice Address - Fax:304-366-9529
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13834207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV080057483OtherRR MEDICARE
WVB59751OtherWV WORKER'S COMP
WV0050765000Medicaid
WV0573010OtherHOME PLAN PEIA AND CHIPS
WVB59751OtherCARELINK
WV0004420425OtherAETNA
WV505821OtherNATIONAL CAPITAL PPO
WVFQ13834OtherHEALTH PLAN
WV000514416OtherMT STATE BC/BS
WV550486849 0013OtherCIGNA
WV1649202060OtherOHIO WORKER'S COMP
WVB59751Medicare UPIN
WVSC0647221Medicare PIN