Provider Demographics
NPI:1588664437
Name:SCHEIDLER, MICHAEL GERARD (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GERARD
Last Name:SCHEIDLER
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 1:1707 W CHARLESTON BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2352
Mailing Address - Country:US
Mailing Address - Phone:702-650-2500
Mailing Address - Fax:702-650-2220
Practice Address - Street 1:1707 W CHARLESTON BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2352
Practice Address - Country:US
Practice Address - Phone:702-650-2500
Practice Address - Fax:702-650-2220
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV109362086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100503619Medicaid