Provider Demographics
NPI:1124028212
Name:SCHMIDT, DIANE NORLAINE (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:NORLAINE
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 1:1021 PARK AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-0130
Mailing Address - Country:US
Mailing Address - Phone:484-526-7300
Mailing Address - Fax:610-791-3107
Practice Address - Street 1:1021 PARK AVE STE 20
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-0130
Practice Address - Country:US
Practice Address - Phone:484-526-7300
Practice Address - Fax:610-791-3107
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-065127-L207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016979550002Medicaid
PA0562533000OtherKEYSTONE EAST
PA2950659OtherAETNA
008803QVYMedicare ID - Type Unspecified
PA0562533000OtherKEYSTONE EAST