Provider Demographics
NPI:1528020377
Name:SCHNEPF, GLENN ADRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:ADRIAN
Last Name:SCHNEPF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GLENN
Other - Middle Name:A
Other - Last Name:SCHNEPF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3284 E BIRCHWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4559
Mailing Address - Country:US
Mailing Address - Phone:480-668-3904
Mailing Address - Fax:480-668-3904
Practice Address - Street 1:3284 E BIRCHWOOD PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-4559
Practice Address - Country:US
Practice Address - Phone:480-668-3904
Practice Address - Fax:480-668-3904
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40956207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ487060Medicaid