Provider Demographics
NPI:1184624249
Name:SCHNEIDER, GEORGE PAUL II (MD)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:PAUL
Last Name:SCHNEIDER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3702 NEW VISION DR
Mailing Address - Street 2:BLDG B
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1703
Mailing Address - Country:US
Mailing Address - Phone:260-563-7421
Mailing Address - Fax:260-563-7725
Practice Address - Street 1:1025 MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-1425
Practice Address - Country:US
Practice Address - Phone:260-563-7421
Practice Address - Fax:260-563-7725
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2018-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01035203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000082845OtherBCBS
IN10337OtherPHP
IN200011100AMedicaid
IN228540DMedicare PIN
IN200011100AMedicaid
IN861730Medicare PIN
IN000000082845OtherBCBS