Provider Demographics
NPI:1700032711
Name:SCHNEIDER, JEFFREY ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ADAM
Last Name:SCHNEIDER
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 1:253 LEWIS LN STE 302
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3757
Mailing Address - Country:US
Mailing Address - Phone:410-942-0620
Mailing Address - Fax:
Practice Address - Street 1:253 LEWIS LN STE 302
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3757
Practice Address - Country:US
Practice Address - Phone:410-942-0620
Practice Address - Fax:410-939-2080
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0071548207LP2900X, 208VP0014X
NJ25MA08509500207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD038685500Medicaid