Provider Demographics
NPI:1518942408
Name:SCHMIDLING, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:SCHMIDLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9406
Mailing Address - Country:US
Mailing Address - Phone:609-652-6815
Mailing Address - Fax:609-652-7153
Practice Address - Street 1:72 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9406
Practice Address - Country:US
Practice Address - Phone:609-652-6815
Practice Address - Fax:609-652-7153
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA068614002085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9128603Medicaid
NJP00847820OtherRAILROAD MEDICARE
NJP00445892OtherRAILROAD MEDICARE
NJP00758337OtherRAILROAD MEDICARE
H80775Medicare UPIN
NJ068458ZDDPMedicare PIN
NJ068458AMLMedicare PIN
NJP00758337OtherRAILROAD MEDICARE