Provider Demographics
NPI:1912950627
Name:SCHNEIDER, EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 MORELAND AVE SE
Mailing Address - Street 2:SUITE C106
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-7000
Mailing Address - Country:US
Mailing Address - Phone:404-627-8998
Mailing Address - Fax:404-591-6890
Practice Address - Street 1:749 MORELAND AVE SE
Practice Address - Street 2:SUITE C106
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-7000
Practice Address - Country:US
Practice Address - Phone:404-627-8998
Practice Address - Fax:404-591-6890
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU94001Medicare UPIN
GA35ZCHDKMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER