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General NPI Number Information
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NPI Number | 1538636865
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Entity Type | Individual
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Provider Name | BRADLEY ROBERT SCHMIDT DVM
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Gender | Male
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 6623 E BLUE LUPINE DR
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City | PALMER
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State | AK
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Zip | 99645-5903
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Country | US
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Telephone | 907-745-8437
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Fax | 907-745-8433
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Provider Business Mailing Address
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Address Line | 6623 E BLUE LUPINE DR
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City | PALMER
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State | AK
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Zip | 99645-5903
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Country | US
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Telephone | 907-745-8437
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Fax | 907-745-8433
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 137686
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License Number State | AK
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