Provider Demographics
NPI:1063486546
Name:SCHMITT, KIM ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:ELAINE
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3855 PLEASANT HILL RD STE 420
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8030
Mailing Address - Country:US
Mailing Address - Phone:770-495-1955
Mailing Address - Fax:770-232-9961
Practice Address - Street 1:3855 PLEASANT HILL RD STE 420
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8030
Practice Address - Country:US
Practice Address - Phone:770-495-1955
Practice Address - Fax:770-232-9961
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG161068207Y00000X
ALACS11006207Y00000X
GA86917207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD64680Medicare UPIN
AL82228Medicare PIN