Provider Demographics
NPI:1780629113
Name:MATTHEW A SCHMID DC PA
Entity Type:Organization
Organization Name:MATTHEW A SCHMID DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-847-3122
Mailing Address - Street 1:7116 SIX FORKS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6157
Mailing Address - Country:US
Mailing Address - Phone:919-847-3122
Mailing Address - Fax:919-847-3148
Practice Address - Street 1:7116 SIX FORKS RD
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6157
Practice Address - Country:US
Practice Address - Phone:919-847-3122
Practice Address - Fax:919-847-3148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012W9OtherBCBS GROUP #