Provider Demographics
NPI:1548236656
Name:SCHMOKE, PATRICIA L
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:L
Last Name:SCHMOKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 LIBERTY HEIGHTS AVE 1080
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-8019
Mailing Address - Country:US
Mailing Address - Phone:410-669-2020
Mailing Address - Fax:410-669-1795
Practice Address - Street 1:2401 LIBERTY HEIGHTS AVE 1080
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-8019
Practice Address - Country:US
Practice Address - Phone:410-669-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022630174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD36109002OtherBLUE CROSS BLUE SHIELD
MD2579046OtherAETNA
MD18002037OtherRAILROAD MEDICARE
MD256981700Medicaid
T7640001OtherBLUE CROSS FEDERAL
MD581P200HMedicare PIN
MD18002037OtherRAILROAD MEDICARE