Provider Demographics
NPI:1679830129
Name:SCHADEGG, ANDREW MARTIN
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MARTIN
Last Name:SCHADEGG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16770 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8736
Mailing Address - Country:US
Mailing Address - Phone:773-331-4590
Mailing Address - Fax:
Practice Address - Street 1:16770 DRY CREEK RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8736
Practice Address - Country:US
Practice Address - Phone:773-331-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker