Provider Demographics
NPI:1477617884
Name:SCHMIDT, DIANE L (CGC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 W 13 MILE RD
Mailing Address - Street 2:SUITE 329, MEDICAL OFFICE BLDG.
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:248-551-0395
Mailing Address - Fax:248-551-3130
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:SUITE 329, MEDICAL OFFICE BLDG.
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-0395
Practice Address - Fax:248-551-3130
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS