Healthcare Provider Details

I. General information

NPI: 1891734075
Provider Name (Legal Business Name): MICHAEL IRA SCHNEIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10105 BANBURRY CROSS DR STE 445
LAS VEGAS NV
89144-6645
US

IV. Provider business mailing address

10105 BANBURRY CROSS DR STE 445
LAS VEGAS NV
89144-6645
US

V. Phone/Fax

Practice location:
  • Phone: 702-475-8454
  • Fax: 702-509-9865
Mailing address:
  • Phone: 702-475-8454
  • Fax: 702-509-9865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number14728
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: