Provider Demographics
NPI:1306906896
Name:SCHAUDER, KEITH S (MD PA)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:S
Last Name:SCHAUDER
Suffix:
Gender:M
Credentials:MD PA
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 7887
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-7800
Mailing Address - Country:US
Mailing Address - Phone:281-331-3100
Mailing Address - Fax:281-756-8463
Practice Address - Street 1:1 MEDIC LN
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-5577
Practice Address - Country:US
Practice Address - Phone:281-331-3100
Practice Address - Fax:281-756-8463
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0791207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB105354Medicare PIN
TX00G33GMedicare PIN
TXTXB105355Medicare PIN
TX84K151Medicare PIN