Provider Demographics
NPI:1558525055
Name:SCHMIDT, MICHAEL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7575 GRAND RIVER RD
Mailing Address - Street 2:LIVINGSTON SURGERY ASSOCIATES, STE 201
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9309
Mailing Address - Country:US
Mailing Address - Phone:810-844-7525
Mailing Address - Fax:810-844-7526
Practice Address - Street 1:7575 GRAND RIVER RD
Practice Address - Street 2:LIVINGSTON SURGERY ASSOCIATES, STE 201
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9309
Practice Address - Country:US
Practice Address - Phone:810-844-7525
Practice Address - Fax:810-844-7526
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35 093635208600000X
MI4301095801208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000008609-00OtherOHIO BUREAU OF WORKERS' COMPENSATION
OH000000622785OtherANTHEM BLUE CROSS AND BLUE SHIELD
OH00753194OtherRAILROAD MEDICARE
9788395OtherAETNA
OH05813OtherPARAMOUNT HEALTH CARE
OH2960729Medicaid
OH341966854OtherHUMANA
OH05813OtherPARAMOUNT HEALTH CARE