MEDICARE: DR. HENRY G SCHRIEVER M.D.

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	207QA0505X	Adult Medicine Physician	25MAO01917900	NJ

General Provider Information

NPI Number	:	1841514510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY G SCHRIEVER M.D.

Provider Business Mailing Address
First Line	:	9 SANDY COVE LN
Second Line	:
City	:	BEACH HAVEN
State	:	NJ
Zip	:	08008-6154
Country	:	US
Telephone Number	:	609-361-0217
Fax Number	:	609-361-0217

Provider Business Practice Location Address
First Line	:	9 SANDY COVE LN
Second Line	:
City	:	BEACH HAVEN
State	:	NJ
Zip	:	08008-6154
Country	:	US
Telephone Number	:	609-361-0217
Fax Number	:	609-361-0217

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

Provider Enumeration Date	:	03/24/2010
Last Update Date	:	03/24/2010

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