MEDICARE: DR. ANDREW H. SCHMITZER O.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	152W00000X	Optometrist	4901004026	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	900B311150	OTHER	MI	BLUE CROSS BLUE SHIELD
2	7323885	OTHER	MI	AETNA
3	200000007557	OTHER	MI	PHP OF MID MICHIGAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	2614422	OTHER	MI	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1841280641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW H. SCHMITZER O.D.

Provider Business Mailing Address
First Line	:	11973 SWEETWATER DR
Second Line	:
City	:	GRAND LEDGE
State	:	MI
Zip	:	48837-9196
Country	:	US
Telephone Number	:	517-622-2020
Fax Number	:	517-627-4397

Provider Business Practice Location Address
First Line	:	11973 SWEETWATER DR
Second Line	:
City	:	GRAND LEDGE
State	:	MI
Zip	:	48837-9196
Country	:	US
Telephone Number	:	517-622-2020
Fax Number	:	517-627-4397

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	05/15/2008

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