Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MEDO6984 | AK |
N | 207Q00000X | Family Doctor | 6984 | AK |
Y | 207Q00000X | Family Doctor | MEDO6984 | AK |
N | 207QA0401X | Family Doctor - Addiction Medicine | MEDO6984 | AK |
NPI | 1093826554 |
---|---|
Provider Name | Dr. Eric L Schneider |
First Address | Fairbanks, AK 99701-4922 |
Second Address | Fairbanks, AK 99701-4922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1570580 | (05) | AK |