Provider Demographics
NPI:1689634982
Name:SCHRADER, DANIEL D (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:SCHRADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:704 W GROVE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4416
Mailing Address - Country:US
Mailing Address - Phone:870-864-6700
Mailing Address - Fax:870-864-6704
Practice Address - Street 1:704 W GROVE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4416
Practice Address - Country:US
Practice Address - Phone:870-864-6700
Practice Address - Fax:870-864-6704
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE3620207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR150038001Medicaid
AR150038001Medicaid
ARH78212Medicare UPIN