Provider Demographics
NPI:1194831149
Name:SCHMIDT, DAVID E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:SCHMIDT
Suffix:JR
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 1:896 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4148
Mailing Address - Country:US
Mailing Address - Phone:302-674-4865
Mailing Address - Fax:302-674-4624
Practice Address - Street 1:896 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4148
Practice Address - Country:US
Practice Address - Phone:302-674-4865
Practice Address - Fax:302-674-4624
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00056402086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE48260OtherCOVENTRY
DE336185OtherAMERIHEALTH
G95885Medicare UPIN
DE490352Medicare ID - Type Unspecified