Provider Demographics
NPI:1417932369
Name:SCHMIDT, DOUGLAS LOU (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:LOU
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MCNEELY DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7623
Mailing Address - Country:US
Mailing Address - Phone:919-781-0304
Mailing Address - Fax:919-781-0305
Practice Address - Street 1:5500 MCNEELY DR
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7623
Practice Address - Country:US
Practice Address - Phone:919-781-0304
Practice Address - Fax:919-781-0305
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08774OtherBCBSNC
NC08774OtherBCBSNC