Provider Demographics
NPI:1992750483
Name:SCHNEIDER, BRENDA K (MD)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:K
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:490A W ZIA RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6996
Mailing Address - Country:US
Mailing Address - Phone:505-989-9772
Mailing Address - Fax:505-989-1446
Practice Address - Street 1:490 A W ZIA RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6996
Practice Address - Country:US
Practice Address - Phone:505-989-9772
Practice Address - Fax:505-989-1446
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM93-147207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
346618001Medicare PIN