Provider Demographics
| NPI: | 1356585590 |
|---|---|
| Name: | SCHLEIFER, JOHN WILLIAM (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | JOHN |
| Middle Name: | WILLIAM |
| Last Name: | SCHLEIFER |
| 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: | 988102 NEBRASKA MEDICAL CTR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | OMAHA |
| Mailing Address - State: | NE |
| Mailing Address - Zip Code: | 68198-8102 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | EMILE AT 42ND ST |
| Practice Address - Street 2: | |
| Practice Address - City: | OMAHA |
| Practice Address - State: | NE |
| Practice Address - Zip Code: | 68198-0001 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 402-559-8888 |
| Practice Address - Fax: | 402-559-3060 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2009-04-30 |
| Last Update Date: | 2022-07-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NE | 29861 | 207RC0001X |
| MN | 59015 | 207RC0001X |
| 390200000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
| No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| AZ | 720052 | Medicaid | |
| AZ | Z92848 | Medicare PIN |