Provider Demographics
NPI:1265521967
Name:SCHROEDER, JANET M (DO)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:M
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 N STALLMAN RD
Mailing Address - Street 2:
Mailing Address - City:PESHAWBESTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9158
Mailing Address - Country:US
Mailing Address - Phone:231-534-6006
Mailing Address - Fax:231-534-7460
Practice Address - Street 1:2300 N STALLMAN RD
Practice Address - Street 2:
Practice Address - City:PESHAWBESTOWN
Practice Address - State:MI
Practice Address - Zip Code:49682-9158
Practice Address - Country:US
Practice Address - Phone:231-534-6006
Practice Address - Fax:231-534-7460
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM65120008Medicare ID - Type UnspecifiedMEDICARE