Healthcare Provider Details

I. General information

NPI: 1033097381
Provider Name (Legal Business Name): ZACHARY K SCHMIDT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4287 FIVE OAKS DR
LANSING MI
48911-4214
US

IV. Provider business mailing address

2521 N ELMS RD
FLUSHING MI
48433-9423
US

V. Phone/Fax

Practice location:
  • Phone: 517-732-2114
  • Fax:
Mailing address:
  • Phone: 810-285-1755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: