Provider Demographics
NPI:1578652293
Name:SCHMIDT, ADAM K (O D)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:K
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18791 JOHN J WILLIAMS HWY
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4401
Mailing Address - Country:US
Mailing Address - Phone:302-645-2300
Mailing Address - Fax:302-645-7214
Practice Address - Street 1:18791 JOHN J. WILLIAMS HIGHWAY
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4401
Practice Address - Country:US
Practice Address - Phone:302-645-2300
Practice Address - Fax:302-645-2329
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001303152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE161525705OtherBCBS
DE11534561OtherCAQH
DEI3-0001303OtherSTATE LICENSE
MD221583YEW4OtherMEDICARE
DEG00016OtherMEDICARE GROUP PIN
MDTA2231OtherSTATE LICENSE MD
MD221583ZERROtherMEDICARE
DE0005OtherEYEMED
DE1000039159Medicaid
MD221583ZERFOtherMEDICARE
MD221583ZERGOtherMEDICARE
1245251313OtherMEDICARE GROUP NPI
DE7465739OtherAETNA
DE0005OtherEYEMED
DE018774H16Medicare ID - Type Unspecified
DE1000039159Medicaid