Provider Demographics
NPI:1619920097
Name:SCHEIDT, TROY DEAN (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:DEAN
Last Name:SCHEIDT
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 1:1000 W NIFONG BLVD
Mailing Address - Street 2:BUILDING 3, SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5615
Mailing Address - Country:US
Mailing Address - Phone:573-214-2000
Mailing Address - Fax:573-214-2042
Practice Address - Street 1:1000 W NIFONG BLVD
Practice Address - Street 2:BUILDING 3, SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5615
Practice Address - Country:US
Practice Address - Phone:573-214-2000
Practice Address - Fax:573-214-2042
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004012772207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209107309Medicaid
MOP00419156OtherRAILROAD MEDICARE
MOP00259184OtherRAILROAD MEDICARE
MO209107309Medicaid
MOP00259184OtherRAILROAD MEDICARE
MO922031109Medicare PIN