Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 4301025920 | MI |
NPI | 1063741536 |
---|---|
Provider Name | Dr. John Raymond Schneider |
First Address | Grosse Pointe, MI 48236-1829 |
Second Address | Grosse Pointe, MI 48236-1829 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2009 |
Last Update Date | 13/12/2009 |