Provider Demographics
NPI:1508945700
Name:SCHMIDT, BRIAN EDWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:EDWARD
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 DOESCHER DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4855
Mailing Address - Country:US
Mailing Address - Phone:504-258-3889
Mailing Address - Fax:504-737-6400
Practice Address - Street 1:3510 SEVERN AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3444
Practice Address - Country:US
Practice Address - Phone:504-455-1777
Practice Address - Fax:504-455-5361
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD185R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1686034Medicaid
721429327OtherIRS TAX
LA43992199DABCOtherBLUE CROSS
LA4A589Medicare ID - Type Unspecified
U64498Medicare UPIN
LA1686034Medicaid