MEDICARE: DR. LANE BERNARD SCHEIBER II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	4301050179	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11-0-82-9274-1	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1346253721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANE BERNARD SCHEIBER II MD

Provider Business Mailing Address
First Line	:	7864 OAK RIVER DR
Second Line	:
City	:	GROSSE ILE
State	:	MI
Zip	:	48138-1378
Country	:	US
Telephone Number	:	734-671-5500
Fax Number	:	734-671-5601

Provider Business Practice Location Address
First Line	:	1680 FORT ST
Second Line	:	SUITE A
City	:	TRENTON
State	:	MI
Zip	:	48183-2003
Country	:	US
Telephone Number	:	734-671-5500
Fax Number	:	734-671-5601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	11/13/2010

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