Provider Demographics
NPI:1417046483
Name:SCHNEIDER, DAVID DUANE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:DUANE
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:PO BOX 26028
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6028
Mailing Address - Country:US
Mailing Address - Phone:505-262-7000
Mailing Address - Fax:505-262-7000
Practice Address - Street 1:101 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3605
Practice Address - Country:US
Practice Address - Phone:505-864-4646
Practice Address - Fax:505-861-1843
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM80-91207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM110144154OtherRR MEDICARE
NM73773OtherCARE
NM742850726OtherCHAMPUS/TRICARE
NM2001008899OtherPRESBYTERIAN HEALTH PLANS
NM27201Medicaid
NM659OtherLOVELACE HEALTH PLANS
NMNM002745OtherBLUE CROSS BLUE SHIELD
NMNM002745OtherBLUE CROSS BLUE SHIELD