Provider Demographics
NPI:1477709830
Name:SHMIDHEISER, MAXIMILLIAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAXIMILLIAN
Middle Name:
Last Name:SHMIDHEISER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 SHORTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1608
Mailing Address - Country:US
Mailing Address - Phone:215-704-6003
Mailing Address - Fax:
Practice Address - Street 1:411 SHORTRIDGE DR
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1608
Practice Address - Country:US
Practice Address - Phone:215-704-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist