Provider Demographics
NPI:1093867517
Name:SCHMIDT, CATHERINE C (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:C
Last Name:SCHMIDT
Suffix:
Gender:F
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:PO BOX 1261
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-1261
Mailing Address - Country:US
Mailing Address - Phone:307-578-1923
Mailing Address - Fax:307-527-3357
Practice Address - Street 1:732 LINDSAY LN
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-4103
Practice Address - Country:US
Practice Address - Phone:307-578-1923
Practice Address - Fax:307-527-3357
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY4226A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107169600Medicaid
WY107169600Medicaid
WY305743Medicare ID - Type Unspecified