Provider Demographics
NPI:1093145690
Name:SCHMIDT, SARAH G (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:G
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-5563
Mailing Address - Country:US
Mailing Address - Phone:706-721-7994
Mailing Address - Fax:706-721-0313
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-5563
Practice Address - Country:US
Practice Address - Phone:706-721-7994
Practice Address - Fax:706-721-0313
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004173133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALD004173OtherLICENSED DIETITIAN