Provider Demographics
NPI:1962635524
Name:SCHMIDT, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
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 1:10 CENTER DRIVE MSC 1277
Mailing Address - Street 2:BLDG 10-CRC ROOM 2-5330
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1277
Mailing Address - Country:US
Mailing Address - Phone:301-496-6120
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DRIVE MSC 1277
Practice Address - Street 2:BLDG 10-CRC ROOM 2-5330
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1277
Practice Address - Country:US
Practice Address - Phone:301-496-6120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00433772084P0800X
VA01010438962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry