Healthcare Provider Details

I. General information

NPI: 1285828376
Provider Name (Legal Business Name): JOHN E SCHMIDT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8955 WOOD RD
BETHESDA MD
20889-5628
US

IV. Provider business mailing address

8955 WOOD RD
BETHESDA MD
20889-5628
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-8193
  • Fax:
Mailing address:
  • Phone: 301-319-8193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP5243
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS017117
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: