Healthcare Provider Details

I. General information

NPI: 1841494564
Provider Name (Legal Business Name): CAROL L SCHMIDT MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1377 CHEWS LANDING RD
LAUREL SPRINGS NJ
08021
US

IV. Provider business mailing address

2 YORKSHIRE DR
VOORHEES NJ
08043-3730
US

V. Phone/Fax

Practice location:
  • Phone: 856-227-3434
  • Fax: 856-227-6001
Mailing address:
  • Phone: 856-772-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA05079700
License Number StateNJ

VIII. Authorized Official

Name: DR. CAROL L SCHMIDT
Title or Position: OWNER PHYSICIAN
Credential: M D
Phone: 856-722-3436