Healthcare Provider Details

I. General information

NPI: 1194831149
Provider Name (Legal Business Name): DAVID E SCHMIDT JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

896 S STATE ST
DOVER DE
19901-4148
US

IV. Provider business mailing address

896 S STATE ST
DOVER DE
19901-4148
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4865
  • Fax: 302-674-4624
Mailing address:
  • Phone: 302-674-4865
  • Fax: 302-674-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberC1-0005640
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: