Individual
SCOTT D SCHRADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
650 ADDISON AVE W, TWIN FALLS, ID 83301-5444
(208) 732-3429
(208) 732-3220
Mailing address
PO BOX 1657, TWIN FALLS, ID 83303-1657
(208) 734-3356
(208) 733-9463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-271
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805592000
—
ID
Enumeration date
06/14/2006
Last updated
12/31/2009
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