Provider Demographics
NPI:1518049022
Name:SCHREIBER, JOHN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:SCHREIBER
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:CONNECTICUT CHILDREN'S SPECIALTY GROUP
Mailing Address - Street 2:282 WASHINGTON SRT.
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3322
Mailing Address - Country:US
Mailing Address - Phone:860-545-9000
Mailing Address - Fax:
Practice Address - Street 1:282 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3322
Practice Address - Country:US
Practice Address - Phone:860-545-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48988208000000X, 2080P0208X
WI674252080P0208X
CT640582080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2213941OtherARAZ
MN604R0SCOtherBLUE CROSS BLUE SHIELD
MT0079832Medicaid
MN132251OtherUCARE
MN547407800Medicaid
MN92-12094OtherMEDICA PRIMARY
MT0079822Medicaid
MN9200168OtherMEDICA CHOICE
WI34565100Medicaid
MNHP45306OtherHEALTH PARTNERS
IA0597468Medicaid
WI1518049022Medicaid
MN1042021OtherPREFERRED ONE