MEDICARE: DR. TODD ANDREW SCHNOBRICH OD

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	152W00000X	Optometrist	OPT1806	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	101542	OTHER	GA	AVESIS

General Provider Information

NPI Number	:	1760588636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD ANDREW SCHNOBRICH OD

Provider Business Mailing Address
First Line	:	1000 TOWNE CENTER BLVD
Second Line	:	STE 502
City	:	POOLER
State	:	GA
Zip	:	31322-4068
Country	:	US
Telephone Number	:	912-826-7462
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 TOWNE CENTER BLVD
Second Line	:	SUITE # 502
City	:	POOLER
State	:	GA
Zip	:	31322-4052
Country	:	US
Telephone Number	:	912-748-1272
Fax Number	:

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	10/24/2019

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