Provider Demographics
NPI:1518082254
Name:SCHNEIDER, DAVID I (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:I
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 ALLEN ST
Mailing Address - Street 2:STE 403
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4570
Mailing Address - Country:US
Mailing Address - Phone:802-772-4414
Mailing Address - Fax:802-772-7973
Practice Address - Street 1:1 GENERAL WING RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4681
Practice Address - Country:US
Practice Address - Phone:802-773-9131
Practice Address - Fax:802-773-1551
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0320000412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01478766Medicaid
0451759-001OtherCIGNA
NH286235OtherCIGNA NH
VT19117OtherVT BLUE CROSS BLUE SHIELD
26221OtherMVP (MOHAWK VALLEY HP)
10020745OtherCDPHP
VT1004258Medicaid
F70794Medicare UPIN
NY01478766Medicaid