Healthcare Provider Details

I. General information

NPI: 1255306791
Provider Name (Legal Business Name): DAVID A SHNEIDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W LAKE LANSING RD SUITE 190
EAST LANSING MI
48823-6371
US

IV. Provider business mailing address

830 W LAKE LANSING RD SUITE 190
EAST LANSING MI
48823-6371
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-3777
  • Fax: 517-203-3956
Mailing address:
  • Phone: 517-333-3777
  • Fax: 517-203-3956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301035039
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: