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General NPI Number Information
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NPI Number | 1184790123
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Entity Type | Individual
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Provider Name | MARLENE JOAN SCHMIDT MD
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 1003 12TH ST
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City | BUTNER
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State | NC
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Zip | 27509-1626
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Country | US
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Telephone | 919-575-7927
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Fax | 919-575-7895
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Provider Business Mailing Address
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Address Line | 1623 WRENN RD
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City | DURHAM
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State | NC
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Zip | 27703-6532
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.057069
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 02724
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License Number State | NC
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