Healthcare Provider Details

I. General information

NPI: 1477716264
Provider Name (Legal Business Name): MELISSA S SCHNEIDER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA S MASSEY O.D.

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 11/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7335 MANCHESTER RD
MAPLEWOOD MO
63143-3107
US

IV. Provider business mailing address

15933 CLAYTON RD SUITE 201
BALLWIN MO
63011-2172
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-1575
  • Fax: 314-645-8001
Mailing address:
  • Phone: 636-200-4393
  • Fax: 636-938-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2008017068
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: