Provider Demographics
NPI:1467539262
Name:SCHMIDT, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:55 WHITCHER ST NE STE 250
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1169
Mailing Address - Country:US
Mailing Address - Phone:770-428-4475
Mailing Address - Fax:770-426-1499
Practice Address - Street 1:55 WHITCHER ST NE STE 250
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1169
Practice Address - Country:US
Practice Address - Phone:770-428-4475
Practice Address - Fax:770-426-1499
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA24490208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA34BDDZMMedicare PIN
GA340014210Medicare PIN