Provider Demographics
NPI:1649371386
Name:SCHNITZER, CARY M (MD)
Entity type:Individual
Prefix:DR
First Name:CARY
Middle Name:M
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 1:18404 N TATUM BLVD
Mailing Address - Street 2:206
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-1510
Mailing Address - Country:US
Mailing Address - Phone:602-867-0111
Mailing Address - Fax:
Practice Address - Street 1:18404 N TATUM BLVD
Practice Address - Street 2:206
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-1510
Practice Address - Country:US
Practice Address - Phone:602-867-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22857207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE95666Medicare UPIN