Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 5101007020 | MI |
NPI | 1295777423 |
---|---|
Provider Name | Dr. Robert P Schneeberger |
First Address | Muskegon, MI 49445-2831 |
Second Address | Muskegon, MI 49442-3759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 24/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1345783 | (05) | MI |
E26682 | (02) | MI |