Provider Demographics
NPI:1093032328
Name:SCHMIDT, BENJAMIN SAMSON (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:SAMSON
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 NC 8 AND 89 HWY N
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27016-7360
Mailing Address - Country:US
Mailing Address - Phone:336-593-5336
Mailing Address - Fax:
Practice Address - Street 1:1570 NC 8 AND 89 HWY N
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:NC
Practice Address - Zip Code:27016-7360
Practice Address - Country:US
Practice Address - Phone:336-593-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01691208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice