Provider Demographics
NPI:1851329783
Name:SCHMIDT, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
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 1:333 SE 7TH AVE
Mailing Address - Street 2:SUITE 4500
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4157
Mailing Address - Country:US
Mailing Address - Phone:503-648-6611
Mailing Address - Fax:503-640-3178
Practice Address - Street 1:333 SE 7TH AVE
Practice Address - Street 2:SUITE 4500
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4157
Practice Address - Country:US
Practice Address - Phone:503-648-6611
Practice Address - Fax:503-640-3178
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21226174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR136335Medicaid
OR110058Medicare ID - Type Unspecified
OR136335Medicaid