MEDICARE: DR. STACEY STEVENS SCHMIEDECKE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician	01072991A	IN
2	207V00000X	Obstetrics & Gynecology Physician	01072991A	IN

General Provider Information

NPI Number	:	1124392741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACEY STEVENS SCHMIEDECKE M.D.

Provider Business Mailing Address
First Line	:	34800 BOB WILSON DR
Second Line	:	DEPT OB/GYN, DIVISION OF MFM
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	619-532-7020
Fax Number	:	619-532-6378

Provider Business Practice Location Address
First Line	:	34800 BOB WILSON DR
Second Line	:	DEPT OB/GYN, DIVISION OF MFM
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	619-532-7020
Fax Number	:	619-532-6378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2012
Last Update Date	:	03/06/2026

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