Healthcare Provider Details

I. General information

NPI: 1568415917
Provider Name (Legal Business Name): WILLIAM FREDERICK SCHMIDT III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W FARIS RD FL 2
GREENVILLE SC
29605-4255
US

IV. Provider business mailing address

1 INDEPENDENCE PT STE 212
GREENVILLE SC
29615-4536
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-8898
  • Fax: 864-455-5164
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number12171
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: