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General NPI Number Information
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NPI Number | 1407951478
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Entity Type | Organization
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Legal Business Name | STEPHEN A. SCHMIDT MD SC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 300 W LINCOLN ST
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City | BELLEVILLE
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State | IL
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Zip | 62220-1987
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Country | US
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Telephone | 618-277-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W. LINCOLN STE 402
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City | BELLEVILLE
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State | IL
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Zip | 62220
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Country | US
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Telephone | 618-277-0475
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Fax | 618-277-0593
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN A SCHMIDT
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Credential | MD
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Telephone | 618-277-0475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036-065962
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License Number State | IL
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