Healthcare Provider Details

I. General information

NPI: 1295777423
Provider Name (Legal Business Name): ROBERT P SCHNEEBERGER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E APPLE AVE
MUSKEGON MI
49442-3759
US

IV. Provider business mailing address

726 LAKE DR
MUSKEGON MI
49445-2831
US

V. Phone/Fax

Practice location:
  • Phone: 231-777-2568
  • Fax: 231-773-4310
Mailing address:
  • Phone: 231-744-1564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number5101007020
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: