Provider Demographics
NPI:1477512242
Name:SCHLEICHERT, DAVID CONRAD (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CONRAD
Last Name:SCHLEICHERT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:49725 COUNTY 83
Mailing Address - Street 2:
Mailing Address - City:STAPLES
Mailing Address - State:MN
Mailing Address - Zip Code:56479-5280
Mailing Address - Country:US
Mailing Address - Phone:218-894-1515
Mailing Address - Fax:218-894-8943
Practice Address - Street 1:49725 COUNTY 83
Practice Address - Street 2:
Practice Address - City:STAPLES
Practice Address - State:MN
Practice Address - Zip Code:56479-5280
Practice Address - Country:US
Practice Address - Phone:218-894-1515
Practice Address - Fax:218-894-8943
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN434213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0203040001OtherADMINISTAR FEDERAL
MN480017358OtherRAILROAD MEDICARE
MN673725100Medicaid
MNHP24928OtherHEALTHPARTNERS
MN111963OtherUCARE
MN26890SCOtherBLUE CROSS BLUE SHIELD
MN959001OtherPREFERRED ONE
MN2723853OtherMEDICA
MNHP24928OtherHEALTHPARTNERS