Provider Demographics
NPI:1396802294
Name:SCHREIBER, SCOTT MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 CITY CENTRE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3381
Mailing Address - Country:US
Mailing Address - Phone:302-507-6725
Mailing Address - Fax:651-768-5059
Practice Address - Street 1:8360 CITY CENTRE DR STE 120
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3381
Practice Address - Country:US
Practice Address - Phone:302-507-6725
Practice Address - Fax:651-768-5059
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000606111N00000X
DEF1-0000606111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1057846OtherCIGNA PPO
DE1701059OtherAMERIHEALTH PPO
DE386606CHIOtherBLUE CROSS AND BLUE SHIEL
DE268577OtherCOVENTRY
DE2372429000OtherAMERIHEALTH HMO
DE1701059OtherAMERIHEALTH PPO
DE386606CHIOtherBLUE CROSS AND BLUE SHIEL