Healthcare Provider Details
I. General information
NPI: 1407992209
Provider Name (Legal Business Name): DAVID M. SCHNEIDER, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4452 EASTGATE BLVD 305
CINCINNATI OH
45245-1584
US
IV. Provider business mailing address
4452 EASTGATE BLVD 305
CINCINNATI OH
45245-1584
US
V. Phone/Fax
- Phone: 513-752-5700
- Fax: 513-752-5716
- Phone: 513-752-5700
- Fax: 513-752-5716
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | 5506/T2418 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
MICHAEL
SCHNEIDER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 513-752-5700