Basic Information
| Provider Information | |||||||||
| NPI: | 1316046436 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHREIBER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 831 ARTHUR DR STE 1 | ||||||||
| Address2: | |||||||||
| City: | MILTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535633728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088683526 | ||||||||
| FaxNumber: | 6088683527 | ||||||||
| Practice Location | |||||||||
| Address1: | 831 ARTHUR DR STE 1 | ||||||||
| Address2: | |||||||||
| City: | MILTON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535633728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088683526 | ||||||||
| FaxNumber: | 6088683527 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 02/26/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 036-089050 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 54743-021 | WI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 54743-021 | 01 | WI | LICENSE | OTHER |