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NPI 1154421352

NPI 1154421352 : MYLES J SCHNEIDER D.P.M : ANNANDALE, VA

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General NPI Number Information
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    NPI Number           |    1154421352
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    Entity Type          |    Individual 
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    Provider Name        |    MYLES J SCHNEIDER D.P.M
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/25/2006
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    Last Update Date     |    12/15/2008
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Provider Practice Location Address
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    Address Line         |    7540 LITTLE RIVER TPKE SUITE I
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    City                 |    ANNANDALE
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    State                |    VA
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    Zip                  |    22003-2839
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    Country              |    US
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    Telephone            |    703-750-1124
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    Fax                  |    703-750-2043
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Provider Business Mailing Address
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    Address Line         |    11525 WILD HAWTHORN CT 
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    City                 |    RESTON
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    State                |    VA
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    Zip                  |    20194-1023
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    Country              |    US
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    Telephone            |    703-750-1124
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    Fax                  |    703-750-2043
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    0103000245
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    License Number State |    VA
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