Provider Demographics
NPI:1972967446
Name:SCHMIDTBERG, BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:SCHMIDTBERG
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 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-4037
Mailing Address - Country:US
Mailing Address - Phone:860-679-6679
Mailing Address - Fax:860-679-6649
Practice Address - Street 1:1111 CROMWELL AVE STE 404
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3455
Practice Address - Country:US
Practice Address - Phone:860-525-4469
Practice Address - Fax:860-278-8032
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT71444207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery