Provider Demographics
NPI:1457367971
Name:SCHNITZER, BRIAN MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:MARTIN
Last Name:SCHNITZER
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 1:3419 CENTRAL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6647
Mailing Address - Country:US
Mailing Address - Phone:406-245-6336
Mailing Address - Fax:406-245-6401
Practice Address - Street 1:3419 CENTRAL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6647
Practice Address - Country:US
Practice Address - Phone:406-245-6336
Practice Address - Fax:406-245-6401
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT 4229174400000X
MT4229207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT001088Medicaid
MT0010881Medicaid
MT001088Medicaid
MTMOOOOO1229Medicare Oscar/Certification
MT0010881Medicaid