Individual
CHARLES SCHROEDER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9330 PARK WEST BLVD, STE 502, KNOXVILLE, TN 37923
(865) 531-3303
(865) 531-1272
Mailing address
9330 PARK WEST BLVD, STE 502, KNOXVILLE, TN 37923
(865) 531-3303
(865) 531-1272
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28382
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3720237
GRP MEDICAID CLAIMS RECIE
SC
01
—
3720237
GRP MEDICARE
—
01
—
3804619
MEDICAID CLAIMS RECIEPT
SC
05
—
3804619
—
TN
01
—
4063853
BLUE CARE - TNCARE
—
01
—
5504519
AETNA
—
01
—
TN0101
JOHN DEERE
—
Enumeration date
07/21/2005
Last updated
07/08/2007
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