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NPI Code Detail

MEDICARE: MR. IAN DANIEL SCHMIDT A.T.,C./L.

MEDICARE: MR. IAN DANIEL SCHMIDT A.T.,C./L.
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
12255A2300XAthletic Trainer36000799AIN

General Provider Information

NPI Number : 1649244195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. IAN DANIEL SCHMIDT A.T.,C./L.
Provider Business Mailing Address
First Line : 201 PENNSYLVANIA PKWY
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46280-2301
Country : US
Telephone Number : 317-208-1562
Fax Number : 317-817-1248
Provider Business Practice Location Address
First Line : 201 PENNSYLVANIA PKWY
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46280-2301
Country : US
Telephone Number : 317-208-1562
Fax Number : 317-817-1248
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 07/08/2007

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