Provider Demographics
NPI:1669645123
Name:SCHMADEKA, ROBERT LEE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:SCHMADEKA
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 1:1185 W MOUNTAIN VIEW RD
Mailing Address - Street 2:#1501
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2523
Mailing Address - Country:US
Mailing Address - Phone:360-909-6459
Mailing Address - Fax:
Practice Address - Street 1:209 N COLLEGE STREET
Practice Address - Street 2:GREENEVILLE PATHOLOGY ASSOCIATES
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745
Practice Address - Country:US
Practice Address - Phone:423-787-5148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000050420207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology