Provider Demographics
NPI:1528076163
Name:SCHNEIDER, MARTHA M (DC)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3473 E. GRAND RIVER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843
Mailing Address - Country:US
Mailing Address - Phone:517-546-4888
Mailing Address - Fax:517-546-5003
Practice Address - Street 1:3473 E. GRAND RIVER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843
Practice Address - Country:US
Practice Address - Phone:517-546-4888
Practice Address - Fax:517-546-5003
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D770609OtherBLUE CROSS BLUE SHIELD
MI3216874Medicaid
MI0D770609OtherBLUE CROSS BLUE SHIELD