Provider Demographics
NPI:1528058773
Name:SCHREIBER, THEODORE L (MD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:L
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8545 COMMON ROAD
Mailing Address - Street 2:STE 150
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-6703
Mailing Address - Country:US
Mailing Address - Phone:586-573-7971
Mailing Address - Fax:586-573-4009
Practice Address - Street 1:8545 COMMON ROAD
Practice Address - Street 2:STE 150
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093
Practice Address - Country:US
Practice Address - Phone:586-573-7971
Practice Address - Fax:586-573-4009
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2018-06-08
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Provider Licenses
StateLicense IDTaxonomies
MI4301053908207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2799575Medicaid
MI2799575Medicaid
C11962Medicare UPIN