Healthcare Provider Details

I. General information

NPI: 1598514028
Provider Name (Legal Business Name): DR. EDWARD P SCHMITT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1362 BALDWIN ST
JENISON MI
49428-8937
US

IV. Provider business mailing address

1551 CAPRICE DR
JENISON MI
49428-9582
US

V. Phone/Fax

Practice location:
  • Phone: 616-901-3696
  • Fax:
Mailing address:
  • Phone: 616-901-3696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDWARD P SCHMITT
Title or Position: OWNER
Credential: PSYD
Phone: 616-901-3696