Provider Demographics
NPI:1053317776
Name:SCHNEIDER, FRED V (MD)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:V
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 1:2900 12TH AVE N
Mailing Address - Street 2:STE 502E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7592
Mailing Address - Country:US
Mailing Address - Phone:406-245-6982
Mailing Address - Fax:406-245-1539
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:STE 502E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7592
Practice Address - Country:US
Practice Address - Phone:406-245-6982
Practice Address - Fax:406-245-1539
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT4125208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0067431Medicaid
MT0067431Medicaid
MT094840Medicare ID - Type UnspecifiedMEDICARE PROVIDER #