Healthcare Provider Details

I. General information

NPI: 1427125970
Provider Name (Legal Business Name): JEFFREY E SCHMIDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOYE BLVD ECU PHYSICIANS PEDIATRICS
GREENVILLE NC
27834-4300
US

IV. Provider business mailing address

PO BOX 751069 ECU PHYSICIANS
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-2335
  • Fax: 252-744-3811
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number43200
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number200701486
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: