Basic Information
| Provider Information | |||||||||
| NPI: | 1659402782 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHNYDER | ||||||||
| FirstName: | DREW | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3164 US HIGHWAY 70 | ||||||||
| Address2: | |||||||||
| City: | BLACK MOUNTAIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287116302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286694505 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3164 US HIGHWAY 70 | ||||||||
| Address2: | |||||||||
| City: | BLACK MOUNTAIN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287116302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286694505 | ||||||||
| FaxNumber: | 8286695112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 09/21/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | H10902 | HI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2012-00350 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 173U3 | 01 | NC | BCBS-NC | OTHER |