Provider Demographics
NPI:1194928853
Name:SCHNEITER, CLAY HOWARD
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:HOWARD
Last Name:SCHNEITER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CLAY
Other - Middle Name:H
Other - Last Name:SCHNEITER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 173862
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3862
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:501 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2702
Practice Address - Country:US
Practice Address - Phone:303-788-6911
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059754207Q00000X, 208M00000X
NY238107207Q00000X
CODR.0048878207Q00000X, 208M00000X
IL036.151264207Q00000X, 208M00000X
CO48878208M00000X
NMMD2014-0939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA655068132DMedicaid
GAP00803290OtherRR MEDICARE
CO07052529Medicaid
SCG59754Medicaid
GA404204OtherWELLCARE
GAP00412718OtherRR MEDICARE
COP01244923OtherRAILROAD MEDICARE
GA655068132AMedicaid
GA01071158OtherAMERIGROUP
CO07052529Medicaid
GA202I086869Medicare PIN
GA655068132AMedicaid