Provider Demographics
NPI:1710584032
Name:SCHONEBERG, DUSTIN (RDCS)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:SCHONEBERG
Suffix:
Gender:M
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30771 ROAD T
Mailing Address - Street 2:
Mailing Address - City:EDGAR
Mailing Address - State:NE
Mailing Address - Zip Code:68935-3192
Mailing Address - Country:US
Mailing Address - Phone:402-469-4828
Mailing Address - Fax:
Practice Address - Street 1:30771 ROAD T
Practice Address - Street 2:
Practice Address - City:EDGAR
Practice Address - State:NE
Practice Address - Zip Code:68935-3192
Practice Address - Country:US
Practice Address - Phone:402-469-4828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE123393246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty