MEDICARE: DR. GARY J SCHMIDT MD

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	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	107985	MO
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	65234	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5547670001	OTHER	MO	DMERC

General Provider Information

NPI Number	:	1447248455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY J SCHMIDT MD

Provider Business Mailing Address
First Line	:	11605 STUDT AVE STE 1
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-7052
Country	:	US
Telephone Number	:	314-699-9818
Fax Number	:	314-699-9868

Provider Business Practice Location Address
First Line	:	799 E HAMPDEN AVE STE 400
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2766
Country	:	US
Telephone Number	:	303-789-2663
Fax Number	:	303-788-4871

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	02/09/2022

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Directions to “ DR. GARY J SCHMIDT MD” Practice Location

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