Provider Demographics
NPI:1588758189
Name:SCHOENBERG, ERIC A (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:SCHOENBERG
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 1:14824 FAIRWAY CT
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-4606
Mailing Address - Country:US
Mailing Address - Phone:913-851-0563
Mailing Address - Fax:
Practice Address - Street 1:14824 FAIRWAY CT
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-4606
Practice Address - Country:US
Practice Address - Phone:913-851-0563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA32506207L00000X
MO2006038824207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00835194HMedicaid
G58237Medicare UPIN
MO152360108Medicare PIN
GA00835194HMedicaid