Provider Demographics
NPI:1023013125
Name:SCHNEIDER, MYRON P (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:P
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3222
Mailing Address - Street 2:DEPT OF IMAGING
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-0293
Mailing Address - Country:US
Mailing Address - Phone:707-261-7822
Mailing Address - Fax:707-256-3508
Practice Address - Street 1:5176 HILL RD E
Practice Address - Street 2:DEPT OF IMAGING
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-6300
Practice Address - Country:US
Practice Address - Phone:707-262-5035
Practice Address - Fax:707-256-3508
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA256032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1309851Medicaid
LA1309851Medicaid
LA5M393Medicare ID - Type Unspecified
CM951Medicare PIN