Provider Demographics
NPI:1881825628
Name:TODD SCHMIDGALL DPM
Entity Type:Organization
Organization Name:TODD SCHMIDGALL DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDGALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:513-421-5160
Mailing Address - Street 1:1548 ADDINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1712
Mailing Address - Country:US
Mailing Address - Phone:513-421-5160
Mailing Address - Fax:
Practice Address - Street 1:1548 ADDINGHAM PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1712
Practice Address - Country:US
Practice Address - Phone:513-421-5160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2010-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-3213213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810016994Medicaid
KY7100128610Medicaid
OHO00206189OtherMEDICARE RAILROAD OH
OH2460420Medicaid
WV4284291Medicare PIN
OHSC4124292Medicare PIN
KY7100128610Medicaid