Provider Demographics
NPI:1346687670
Name:SHNAYDERMAN, DMITRIY (MD)
Entity Type:Individual
Prefix:
First Name:DMITRIY
Middle Name:
Last Name:SHNAYDERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 CHERRY LN STE 116
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-4398
Mailing Address - Country:US
Mailing Address - Phone:209-647-2184
Mailing Address - Fax:414-259-9290
Practice Address - Street 1:250 CHERRY LN STE 116
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-4398
Practice Address - Country:US
Practice Address - Phone:209-647-2184
Practice Address - Fax:414-259-9290
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2022-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1673612085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology