MEDICARE: MICHAEL BRYAN RONALD SCHMIDT PH.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	390200000X	Student in an Organized Health Care Education/Training Program	6352000499	MI
2	103T00000X	Psychologist	6351004920APP25	MI

General Provider Information

NPI Number	:	1639913627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BRYAN RONALD SCHMIDT PH.D.

Provider Business Mailing Address
First Line	:	210 S 5TH AVE
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-2216
Country	:	US
Telephone Number	:	734-764-3471
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 S 5TH AVE
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-2216
Country	:	US
Telephone Number	:	734-764-3471
Fax Number	:

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

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	02/18/2026

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