Provider Demographics
NPI:1629078977
Name:SCHMITT, THOMAS JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOSEPH
Last Name:SCHMITT
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 1:1817 WARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-7114
Mailing Address - Country:US
Mailing Address - Phone:304-277-4405
Mailing Address - Fax:304-277-5200
Practice Address - Street 1:1817 WARWOOD AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-7114
Practice Address - Country:US
Practice Address - Phone:304-277-4405
Practice Address - Fax:304-277-5200
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0087601000Medicaid
WV0087601000Medicaid
WVSC0434356Medicare ID - Type Unspecified
WVC35124Medicare UPIN