Provider Demographics
NPI:1104898550
Name:SCHROEDER, HARMONY R (MD)
Entity type:Individual
Prefix:
First Name:HARMONY
Middle Name:R
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 E. LOUISE DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-955-0350
Mailing Address - Fax:208-955-0352
Practice Address - Street 1:4465 CORDATA PKWY STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8037
Practice Address - Country:US
Practice Address - Phone:360-752-5280
Practice Address - Fax:360-752-5282
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM7450207V00000X
OHM7450207V00000X
WAMD61474775207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010004627OtherREGENCE BLUE SHIELD OF ID
ID805126400Medicaid
ID59709OtherBLUE CROSS OF ID
ID218583649OtherTRIWEST; MILITARY INS
ID1139002Medicare ID - Type Unspecified
ID000010004627OtherREGENCE BLUE SHIELD OF ID