Provider Demographics
NPI:1710994314
Name:SCHNEIDERMANN, MICHELLE E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:E
Last Name:SCHNEIDERMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:DEPT. OF MEDICINE, 5H
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-4462
Mailing Address - Fax:415-206-5126
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:DEPT. OF MEDICINE, 5H
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-4462
Practice Address - Fax:415-206-5126
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A722140Medicaid
H73449Medicare UPIN
CA00A722140Medicaid