Provider Demographics
NPI:1790788933
Name:SCHMIDT, WAYNE E (DC)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:E
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 CLAREMONT AVE
Mailing Address - Street 2:STE 5A
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805
Mailing Address - Country:US
Mailing Address - Phone:419-281-4531
Mailing Address - Fax:419-281-4533
Practice Address - Street 1:1430 CLAREMONT AVE
Practice Address - Street 2:STE 5A
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3564
Practice Address - Country:US
Practice Address - Phone:419-281-4531
Practice Address - Fax:419-281-4533
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0396914Medicaid
1790788933OtherNPI
OH0396914Medicaid
OH0475874Medicare ID - Type Unspecified