Healthcare Provider Details

I. General information

NPI: 1588758189
Provider Name (Legal Business Name): ERIC A SCHOENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14824 FAIRWAY CT
LEAWOOD KS
66224-4606
US

IV. Provider business mailing address

14824 FAIRWAY CT
LEAWOOD KS
66224-4606
US

V. Phone/Fax

Practice location:
  • Phone: 913-851-0563
  • Fax:
Mailing address:
  • Phone: 913-851-0563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number32506
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2006038824
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: