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General NPI Number Information
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NPI Number | 1295797421
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Entity Type | Organization
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Legal Business Name | DOUGLAS SCHNEIDER OD PC
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 1933 N MITCHELL ST
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City | CADILLAC
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State | MI
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Zip | 49601-1139
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Country | US
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Telephone | 231-775-6555
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Fax | 231-775-6648
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Provider Business Mailing Address
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Address Line | 1933 N MITCHELL ST
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City | CADILLAC
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State | MI
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Zip | 49601-1139
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Country | US
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Telephone | 231-775-6555
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Fax | 231-775-6648
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS E. SCHNEIDER
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Credential | OD
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Telephone | 231-775-6555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002791
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License Number State | MI
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