Provider Demographics
NPI:1780688481
Name:SCHMIDT, ROBERT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:SCHMIDT
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:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-0447
Mailing Address - Country:US
Mailing Address - Phone:814-781-7531
Mailing Address - Fax:814-781-7494
Practice Address - Street 1:177 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1349
Practice Address - Country:US
Practice Address - Phone:814-781-7531
Practice Address - Fax:814-781-7494
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022292E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101736519Medicaid
PAC30471Medicare UPIN
PA101736519Medicaid