Provider Demographics
NPI:1578537759
Name:SCHMIEDER, GEORGE J (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:SCHMIEDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 160295
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32716-0295
Mailing Address - Country:US
Mailing Address - Phone:904-541-0315
Mailing Address - Fax:904-541-0316
Practice Address - Street 1:906 PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4120
Practice Address - Country:US
Practice Address - Phone:904-541-0315
Practice Address - Fax:904-541-0316
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS4926207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDE6922OtherRAILROAD MEDICARE
K9927Medicare PIN
FLH24358Medicare UPIN