Provider Demographics
NPI:1871662965
Name:SCHROEDER, WILLIAM G (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:SCHROEDER
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 FENBROOK WAY SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1680
Mailing Address - Country:US
Mailing Address - Phone:908-229-4667
Mailing Address - Fax:
Practice Address - Street 1:356 FENBROOK WAY SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1680
Practice Address - Country:US
Practice Address - Phone:908-229-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00320400111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
4316788OtherAETNA PROV #
U24647Medicare UPIN
4316788OtherAETNA PROV #