Provider Demographics
NPI:1386651891
Name:SCHMITT, ED A (MD)
Entity Type:Individual
Prefix:
First Name:ED
Middle Name:A
Last Name:SCHMITT
Suffix:
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 1:4130 THREE GRACES DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-4607
Mailing Address - Country:US
Mailing Address - Phone:719-685-4556
Mailing Address - Fax:
Practice Address - Street 1:4130 THREE GRACES DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-4607
Practice Address - Country:US
Practice Address - Phone:719-685-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5801208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery