Provider Demographics
NPI:1124042767
Name:SCHMIDT, WAYNE PATRICK (MS, MPT)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:PATRICK
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MS, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3824
Mailing Address - Country:US
Mailing Address - Phone:724-229-8812
Mailing Address - Fax:
Practice Address - Street 1:227 DEMAR BLVD
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-2270
Practice Address - Country:US
Practice Address - Phone:724-745-6055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00013339340OtherHIGHMARK PROVIDER NUMBER