Provider Demographics
NPI:1457488025
Name:SCHROEDER, HARRY W JR (MD, PHD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:W
Last Name:SCHROEDER
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:1825 UNIVERSITY BLVD
Practice Address - Street 2:SHELBY 401
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-934-1522
Practice Address - Fax:205-975-6352
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14366170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051592523OtherBCBS
AL103245Medicaid
AL103248Medicaid
AL103249Medicaid
ALP00839375OtherRAILROAD MEDICARE
AL051592516OtherBCBS
AL051592520OtherBCBS
AL103247Medicaid
AL051592515OtherBCBS
AL051592515OtherBCBS
AL103249Medicaid