Provider Demographics
NPI:1598962946
Name:SCHRADER, CHRISTIAN CORD (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:CORD
Last Name:SCHRADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 NASHVILLE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4101
Mailing Address - Country:US
Mailing Address - Phone:615-745-9058
Mailing Address - Fax:
Practice Address - Street 1:958 COLLETT AVE STE 322
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2309
Practice Address - Country:US
Practice Address - Phone:615-745-9058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT92372084P0800X
HIMD-182342084P0800X
KY590092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100977410Medicaid