Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1413 | WI |
NPI | 1003835778 |
---|---|
Provider Name | Todd M Schneider |
First Address | Beaver Dam, WI 53916-3053 |
Second Address | Beaver Dam, WI 53916-3053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 11/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1006595 | PHYSICIANS PLUS HMO (01) | WI |
10365 | CEAN CARE HMO (01) | WI |
12233 | NETWORK HEALTH PLAN (01) | WI |
38562000 | (05) | WI |
391156156 | TAX ID (01) | |
39115615603 | UNITY HMO (01) | WI |
410032599 | RAIL ROAD MEDICARE (01) | WI |
T63247 | (02) | |
WI0117 | JOHN DEERE HEALTH PLAN (01) |