Healthcare Provider Details

I. General information

NPI: 1710102835
Provider Name (Legal Business Name): GEORGE MICHAEL SCHREINER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N. MORRISON, SUITE G
HAMMOND LA
70401-3850
US

IV. Provider business mailing address

620 N MORRISON BLVD SUITE G
HAMMOND LA
70401-2312
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-4113
  • Fax: 985-543-4109
Mailing address:
  • Phone: 985-543-4113
  • Fax: 985-543-4109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number919
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number919
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: