Provider Demographics
NPI:1255544268
Name:SCHREINER, MITCHAL ARIC (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHAL
Middle Name:ARIC
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 1:7788 JEFFERSON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4342
Mailing Address - Country:US
Mailing Address - Phone:505-999-1600
Mailing Address - Fax:505-999-1654
Practice Address - Street 1:7788 JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4342
Practice Address - Country:US
Practice Address - Phone:505-999-1600
Practice Address - Fax:505-999-1654
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26494390200000X
NMMD2009-0489207RG0100X
WAMD60086278207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1255544268Medicaid