Provider Demographics
NPI:1710102835
Name:SCHREINER, GEORGE MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:MICHAEL
Last Name:SCHREINER
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 1:620 N MORRISON BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2312
Mailing Address - Country:US
Mailing Address - Phone:985-543-4113
Mailing Address - Fax:985-543-4109
Practice Address - Street 1:620 N. MORRISON,
Practice Address - Street 2:SUITE G
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3850
Practice Address - Country:US
Practice Address - Phone:985-543-4113
Practice Address - Fax:985-543-4109
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA919103T00000X, 103TM1800X
LA103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1043264251OtherNPI FACILITY