Provider Demographics
NPI:1831208412
Name:SCHNEIDER, JASON S (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:S
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:49 JESSE HILL JR DR SE
Mailing Address - Street 2:DIVISION OF GENERAL MEDICINE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3049
Mailing Address - Country:US
Mailing Address - Phone:404-778-1642
Mailing Address - Fax:404-778-1602
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:GRADY MEMORIAL HOSPITAL PRIMARY CARE CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-4396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH95244Medicare UPIN
GA11BDXDSMedicare ID - Type Unspecified