Provider Demographics
NPI:1689916603
Name:SCHMELZER, MICHAEL T (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:SCHMELZER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 LIMESTONE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5500
Mailing Address - Country:US
Mailing Address - Phone:302-999-9202
Mailing Address - Fax:
Practice Address - Street 1:2060 LIMESTONE RD STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5500
Practice Address - Country:US
Practice Address - Phone:302-999-9202
Practice Address - Fax:302-999-9203
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002978225100000X, 208100000X
PAPT023376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP01461871OtherMEDICARE RR
PAP01461871OtherMEDICARE RR
PA352762VKFMedicare PIN