Basic Information
| Provider Information | |||||||||
| NPI: | 1649202060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHROERING | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1322 LOCUST AVE | ||||||||
| Address2: | PO BOX 1112 | ||||||||
| City: | FAIRMONT | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043660700 | ||||||||
| FaxNumber: | 3043669529 | ||||||||
| Practice Location | |||||||||
| Address1: | 1322 LOCUST AVE | ||||||||
| Address2: | |||||||||
| City: | FAIRMONT | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043660700 | ||||||||
| FaxNumber: | 3043669529 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 12/20/2011 | ||||||||
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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 | 207Q00000X | 13834 | WV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 080057483 | 01 | WV | RR MEDICARE | OTHER | B59751 | 01 | WV | WV WORKER'S COMP | OTHER | 0050765000 | 05 | WV | MEDICAID | 0573010 | 01 | WV | HOME PLAN PEIA AND CHIPS | OTHER | B59751 | 01 | WV | CARELINK | OTHER | 0004420425 | 01 | WV | AETNA | OTHER | 505821 | 01 | WV | NATIONAL CAPITAL PPO | OTHER | FQ13834 | 01 | WV | HEALTH PLAN | OTHER | 000514416 | 01 | WV | MT STATE BC/BS | OTHER | 550486849 0013 | 01 | WV | CIGNA | OTHER | 1649202060 | 01 | WV | OHIO WORKER'S COMP | OTHER |