Provider Demographics
NPI:1487814042
Name:SCHNEIDER, HYON KYONG (MD)
Entity type:Individual
Prefix:DR
First Name:HYON
Middle Name:KYONG
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:253 LEWIS LN
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3750
Mailing Address - Country:US
Mailing Address - Phone:410-942-0620
Mailing Address - Fax:410-939-2080
Practice Address - Street 1:253 LEWIS LN
Practice Address - Street 2:SUITE 302
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3750
Practice Address - Country:US
Practice Address - Phone:410-942-0620
Practice Address - Fax:410-939-2080
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00730232081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6444390001OtherPTAN
MD421067100Medicaid
MD1154752202Medicare NSC