Basic Information
Provider Information
NPI: 1639172000
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHNEIDMILLER
FirstName: JAMES
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1720 LOUISIANA BLVD NE
Address2: STE 401
City: ALBUQUERQUE
State: NM
PostalCode: 871107020
CountryCode: US
TelephoneNumber: 5052604300
FaxNumber: 5052604338
Practice Location
Address1: 1100 CENTRAL AVE SE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871064930
CountryCode: US
TelephoneNumber: 5058411234
FaxNumber: 5058411956
Other Information
ProviderEnumerationDate: 05/31/2005
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X2004-0134NMY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
8607205NM MEDICAID
96090001NMPRONET / AETNAOTHER
NM009R6201NMBLUE CROSS BLUE SHEILDOTHER
1648279405NM MEDICAID
85018205AZ MEDICAID


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