Provider Demographics
NPI:1104085174
Name:SCHROEDER, RENEE C (DO)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:C
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 10TH AVE W
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-1328
Mailing Address - Country:US
Mailing Address - Phone:715-209-8346
Mailing Address - Fax:
Practice Address - Street 1:213 10TH AVE W
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1328
Practice Address - Country:US
Practice Address - Phone:715-209-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54798-21207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine