Provider Demographics
NPI:1124090022
Name:SCHREIBER, MARK T (MD)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:T
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 LYNNHAVEN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7371
Mailing Address - Country:US
Mailing Address - Phone:757-802-4500
Mailing Address - Fax:757-226-9002
Practice Address - Street 1:596 LYNNHAVEN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7371
Practice Address - Country:US
Practice Address - Phone:757-802-4500
Practice Address - Fax:757-226-9002
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1010297432084P0800X
VA01010312222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
000275OtherVALUE OPTIONS
094978OtherANTHEM HEALTHKEEPERS
132792OtherMANAGED HEALTH NETWORK
213535OtherMAMSI
066367OtherMAGELLAN
C01884OtherMCARE GROUP #
094978OtherANTHEM PPO
30001OtherCIGNA
38412401OtherMULTIPLAN
VA007160798Medicaid
087113OtherSENTARA OPTIMA
094978OtherBCBS
260018087OtherMCARE RAILROAD
VA007160798Medicaid
132792OtherMANAGED HEALTH NETWORK