Healthcare Provider Details

I. General information

NPI: 1184652992
Provider Name (Legal Business Name): ROBERT J SCHNEIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 N BALLAS RD STE 500D
SAINT LOUIS MO
63131-2330
US

IV. Provider business mailing address

670 MASON RIDGE CENTER DR STE 300
SAINT LOUIS MO
63141-8573
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-7930
  • Fax: 314-996-7935
Mailing address:
  • Phone: 314-996-7930
  • Fax: 314-996-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberR9200
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: