Provider Demographics
NPI:1629073853
Name:SCHNITTKER, JOSEPH B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:SCHNITTKER
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 1:3245 HEALTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 ARCADE AVE
Practice Address - Street 2:STE 200
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2485
Practice Address - Country:US
Practice Address - Phone:574-232-7227
Practice Address - Fax:574-232-2064
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01046036A207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000686446OtherBCBS BMG NORTH CENTRAL NEUROSURGERY SOUTH BEND
IN200133900AMedicaid
INP00933724OtherRR MEDICARE
INP00933724OtherRR MEDICARE
IN200133900AMedicaid
INM400033277Medicare PIN