Provider Demographics
NPI:1164712790
Name:SCHNEIDER, BERND GUNTER (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:BERND
Middle Name:GUNTER
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-4820
Mailing Address - Country:US
Mailing Address - Phone:810-984-5108
Mailing Address - Fax:810-984-9592
Practice Address - Street 1:1607 24TH ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-4820
Practice Address - Country:US
Practice Address - Phone:810-984-5108
Practice Address - Fax:810-984-9592
Is Sole Proprietor?:No
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist