MEDICARE: MRS. MARTHA ANN SCHMIDT BC-HIS

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	237700000X	Hearing Instrument Specialist	17000729A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000230552	OTHER	OH	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1487623930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA ANN SCHMIDT BC-HIS

Provider Business Mailing Address
First Line	:	319 BOUNDRY ST
Second Line	:
City	:	CAMBRIDGE CITY
State	:	IN
Zip	:	47327-1517
Country	:	US
Telephone Number	:	765-478-3854
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 E MAIN ST
Second Line	:
City	:	CAMBRIDGE CITY
State	:	IN
Zip	:	47327-1219
Country	:	US
Telephone Number	:	765-478-9255
Fax Number	:	765-478-9265

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2007

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