Provider Demographics
NPI:1194758565
Name:SCHRADING, WALTER
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:SCHRADING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-3423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 11TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-3423
Practice Address - Country:US
Practice Address - Phone:205-930-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34343207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA182874OtherHIGHMARK BLUE SHIELD-YH
PA33723OtherGEISINGER-YH
PA1537588OtherGATEWAY-YH
PA001571318Medicaid
PA1141128OtherAMERIHEALTH MERCY-YH
PA50067244OtherCAPITAL BLUE CROSS-YH
PA0090464000OtherAMERIHEALTH 65 PA-YH
PA182874OtherHIGHMARK BLUE SHIELD-YH
B40825Medicare UPIN