Provider Demographics
NPI:1487626297
Name:SCHMELZER, RODNEY E (MD, PLLC)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:E
Last Name:SCHMELZER
Suffix:
Gender:M
Credentials:MD, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5089 S 900 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5735
Mailing Address - Country:US
Mailing Address - Phone:801-743-0700
Mailing Address - Fax:801-743-0701
Practice Address - Street 1:5089 S 900 E
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5735
Practice Address - Country:US
Practice Address - Phone:801-743-0700
Practice Address - Fax:801-743-0701
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT5884684208200000X
AZ41881208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1487626297Medicaid
UT1487626297Medicaid
UT000061466Medicare PIN