Provider Demographics
NPI:1184614141
Name:SCHREIBER, JOSEPH EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 PENCO RD
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3813
Mailing Address - Country:US
Mailing Address - Phone:304-723-2800
Mailing Address - Fax:304-723-2877
Practice Address - Street 1:334 PENCO RD
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3813
Practice Address - Country:US
Practice Address - Phone:304-723-2800
Practice Address - Fax:304-723-2877
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0049412000Medicaid
OH0413510Medicaid
WV0049412000Medicaid
SC0468374Medicare ID - Type Unspecified