Provider Demographics
NPI:1922007368
Name:SCHMIDT, ERIC E (OD)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:E
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E BROAD ST
Mailing Address - Street 2:PO BOX 2589
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-8807
Mailing Address - Country:US
Mailing Address - Phone:910-862-4268
Mailing Address - Fax:910-862-2057
Practice Address - Street 1:409 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-8807
Practice Address - Country:US
Practice Address - Phone:910-862-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1446152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890982HMedicaid
NCUO2621Medicare UPIN
NC2467960AMedicare ID - Type Unspecified