MEDICARE: BRENDA K SCHNEIDER 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	207N00000X	Dermatology Physician	93-147	NM

General Provider Information

NPI Number	:	1992750483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA K SCHNEIDER M.D.

Provider Business Mailing Address
First Line	:	490A W ZIA RD
Second Line	:	SUITE 205
City	:	SANTA FE
State	:	NM
Zip	:	87505-6996
Country	:	US
Telephone Number	:	505-989-9772
Fax Number	:	505-989-1446

Provider Business Practice Location Address
First Line	:	490 A W ZIA RD
Second Line	:	SUITE 205
City	:	SANTA FE
State	:	NM
Zip	:	87505-6996
Country	:	US
Telephone Number	:	505-989-9772
Fax Number	:	505-989-1446

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	10/16/2008

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