Healthcare Provider Details

I. General information

NPI: 1427209402
Provider Name (Legal Business Name): DAVID E. SCHMIDT JR., M.D.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST. SUITE 230
DOVER DE
19904
US

IV. Provider business mailing address

200 BANNING STREET SUITE 230
DOVER DE
19904
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 Number
License Number State

VIII. Authorized Official

Name: MS. JOAN CAULK
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-674-4865