Healthcare Provider Details

I. General information

NPI: 1467364802
Provider Name (Legal Business Name): MR. BEN SCHMIDT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4970 CARROLL EASTERN RD
CARROLL OH
43112-9658
US

IV. Provider business mailing address

4970 CARROLL EASTERN RD
CARROLL OH
43112-9658
US

V. Phone/Fax

Practice location:
  • Phone: 740-953-1533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN.449812
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: