Provider Demographics
NPI:1073754271
Name:SCHMIDT, TREVOR ANDREAS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:ANDREAS
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 E FOREMASTER DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4495
Mailing Address - Country:US
Mailing Address - Phone:435-628-9393
Mailing Address - Fax:435-628-9382
Practice Address - Street 1:1490 E FOREMASTER DR STE 150
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4495
Practice Address - Country:US
Practice Address - Phone:435-628-9393
Practice Address - Fax:435-628-9382
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7246882-1206363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPA16539AOtherPPIN