Provider Demographics
NPI:1841268745
Name:SCHREIBMAN, KEN L (MD PHD)
Entity type:Individual
Prefix:
First Name:KEN
Middle Name:L
Last Name:SCHREIBMAN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6900 E CAMELBACK RD STE 700
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2400
Mailing Address - Country:US
Mailing Address - Phone:480-809-4829
Mailing Address - Fax:623-322-6147
Practice Address - Street 1:9582 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-6992
Practice Address - Country:US
Practice Address - Phone:407-363-6700
Practice Address - Fax:407-363-5979
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1264202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME126420OtherMEDICAL LICENSE