Provider Demographics
NPI:1851398200
Name:SCHMIDT, CHRISTOPHER W (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:W
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 27TH ST
Mailing Address - Street 2:BLDG C SUITE 205
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2677
Mailing Address - Country:US
Mailing Address - Phone:740-355-1900
Mailing Address - Fax:740-355-1909
Practice Address - Street 1:1735 27TH ST
Practice Address - Street 2:BLDG C SUITE 205
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2677
Practice Address - Country:US
Practice Address - Phone:740-355-1900
Practice Address - Fax:740-355-1909
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008089208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2428984Medicaid
OH9337441Medicare PIN
OHF50884Medicare UPIN