Provider Demographics
NPI:1386641587
Name:SCHREIER, ERIC M (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:SCHREIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 E DUPONT RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1545
Mailing Address - Country:US
Mailing Address - Phone:260-373-9700
Mailing Address - Fax:260-373-9740
Practice Address - Street 1:3909 NEW VISION DR
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1725
Practice Address - Country:US
Practice Address - Phone:260-469-6602
Practice Address - Fax:260-458-5664
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN02001837A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2037450Medicaid
IN250007771OtherRR MEDICARE
INP00867166OtherMEDICARE RR
IN200127140Medicaid
MI4819336Medicaid
INM100018536Medicare PIN
OH2037450Medicaid
IN132000AMedicare PIN
IN250007771OtherRR MEDICARE
E32714Medicare UPIN
INP00867166OtherMEDICARE RR
MI4819336Medicaid