Healthcare Provider Details

I. General information

NPI: 1235204330
Provider Name (Legal Business Name): PAUL DAVID SCHNEIDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 NEWBURG RD SUITE 250
LOUISVILLE KY
40218-2497
US

IV. Provider business mailing address

3430 NEWBURG RD STE 250
LOUISVILLE KY
40218-2458
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-3963
  • Fax: 502-897-1792
Mailing address:
  • Phone: 502-893-3963
  • Fax: 502-897-1792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number21221
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: