Provider Demographics
NPI:1255306791
Name:SHNEIDER, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:830 W LAKE LANSING RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6371
Mailing Address - Country:US
Mailing Address - Phone:517-333-3777
Mailing Address - Fax:517-203-3956
Practice Address - Street 1:830 W LAKE LANSING RD
Practice Address - Street 2:SUITE 190
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6371
Practice Address - Country:US
Practice Address - Phone:517-333-3777
Practice Address - Fax:517-203-3956
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2014-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301035039207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200C313650OtherBCBS MI
MI300040412OtherTRICARE
MI200000001151OtherPHYSICIANS HEALTH PLAN
MI200C313650OtherBLUECARE NETWORK
MI1017934OtherMCLAREN HEALTH ADVANTAGE
MI4839704Medicaid
MIB44826Medicare UPIN
MI200000001151OtherPHYSICIANS HEALTH PLAN