Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 07277 | IA |
NPI | 1083690424 |
---|---|
Provider Name | Dr. Robert L Schneider |
First Address | Iowa City, IA 52242 |
Second Address | Iowa City, IA 52242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 07/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0458935 | (05) | IA |
T01268 | (02) |