Provider Demographics
NPI:1720548167
Name:SCHRODER, PAIGE ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:SCHRODER
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:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:7991 BEECHMONT AVE STE C
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3191
Practice Address - Country:US
Practice Address - Phone:513-401-5968
Practice Address - Fax:833-972-4769
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.151355208VP0000X
KY59416208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100982260Medicaid
6535319OtherCIGNA PIN
1351637-0001OtherOHIO BWC
CS2419900262OtherCARESOURCE
KYPDZ000001845698OtherAETNA BETTER HEALTH OF KY
OH0049451Medicaid
IN300092194Medicaid
KYQMP000006287572OtherPASSPORT BY MOLINA