Provider Demographics
NPI:1710969175
Name:SCHREINER, CARL S (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:S
Last Name:SCHREINER
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 1:2423 NW TROOST ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1706
Mailing Address - Country:US
Mailing Address - Phone:541-677-3400
Mailing Address - Fax:541-677-3405
Practice Address - Street 1:2423 NW TROOST ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1706
Practice Address - Country:US
Practice Address - Phone:541-677-3400
Practice Address - Fax:541-677-3405
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21871207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR139496Medicaid
OR139496Medicaid
F92582Medicare UPIN