Provider Demographics
NPI:1154421352
Name:SCHNEIDER, MYLES J (DPM)
Entity type:Individual
Prefix:
First Name:MYLES
Middle Name:J
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:11525 WILD HAWTHORN CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1023
Mailing Address - Country:US
Mailing Address - Phone:703-750-1124
Mailing Address - Fax:703-750-2043
Practice Address - Street 1:7540 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE I
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2839
Practice Address - Country:US
Practice Address - Phone:703-750-1124
Practice Address - Fax:703-750-2043
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0103000245213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
81343OtherMEDICARE RAILROAD
20194OtherOPT CHICE/MAMSI/ALLIANCE
DC71220001OtherBLUE CROSS FEDERAL
VA9332294Medicaid
VA4090314OtherAETNA
VA290570OtherBLUE CROSS VIRIGINIA
435496OtherSOUTH HEALTH
VA290570OtherBLUE CROSS VIRIGINIA
DC71220001OtherBLUE CROSS FEDERAL
VAT30860Medicare UPIN