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General NPI Number Information
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NPI Number | 1679800122
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Entity Type | Organization
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Legal Business Name | GARY E. SCHNITKER MDPA
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 7300 FRANCE AVE S SUITE 100
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City | EDINA
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State | MN
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Zip | 55435-4525
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Country | US
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Telephone | 612-872-4427
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Fax | 612-872-4428
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Provider Business Mailing Address
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Address Line | 7300 FRANCE AVE S SUITE 100
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City | EDINA
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State | MN
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Zip | 55435-4525
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Country | US
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Telephone | 612-872-4427
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Fax | 612-872-4428
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. GARY E. SCHNITKER
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Credential | MD
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Telephone | 612-872-4427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1065
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License Number State | MN
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