Provider Demographics
NPI:1043242233
Name:SCHNEIDER, CRYSTAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAN
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WESTHAMPTON STA
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3330
Mailing Address - Country:US
Mailing Address - Phone:804-287-4200
Mailing Address - Fax:
Practice Address - Street 1:400 WESTHAMPTON STA
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3330
Practice Address - Country:US
Practice Address - Phone:804-443-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244778207W00000X
MDD0062965207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2137362OtherMAMSI
521692515OtherUNITED HEALTH CARE
A5650006OtherNCA FEDERAL
64670701OtherCAREFIRST BCBS
2137362OtherMDIPA
2137362OtherOPTIMUM CHOICE
07694717OtherAETNA PPO
2137362OtherALLIANCE PPO
9411626OtherPHCS
64670701OtherCAREFIRST BCBS
2137362OtherALLIANCE PPO