Healthcare Provider Details

I. General information

NPI: 1801476890
Provider Name (Legal Business Name): MARY ELIZABETH SCHMIDT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MSC10 5590 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

12601 CARMEL CT NE
ALBUQUERQUE NM
87122-4309
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-3909
  • Fax: 505-272-6845
Mailing address:
  • Phone: 214-733-6079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO2024-0063
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: