Provider Demographics
NPI:1841209202
Name:SCHMALFUSS, CARSTEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARSTEN
Middle Name:M
Last Name:SCHMALFUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARSTEN
Other - Middle Name:M
Other - Last Name:SCHMALFUSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-9079
Mailing Address - Fax:352-374-6153
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-9079
Practice Address - Fax:352-374-6153
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76980207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264936500Medicaid
H68988Medicare UPIN
62086ZMedicare PIN