Healthcare Provider Details

I. General information

NPI: 1821139494
Provider Name (Legal Business Name): HERNAN SAMUEL SCHMIDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 02/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 HIGH ST
EUGENE OR
97401-3238
US

IV. Provider business mailing address

1115 BETHEL RD
COLUMBUS OH
43220-2690
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-8437
  • Fax:
Mailing address:
  • Phone: 614-596-4644
  • Fax: 614-451-2017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD173863
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.041638
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: