Provider Demographics
NPI:1013981901
Name:SCHMIDT, MICAH DREW (MD)
Entity type:Individual
Prefix:DR
First Name:MICAH
Middle Name:DREW
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 1:200 CONCORD PLAZA DR STE 780
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6972
Mailing Address - Country:US
Mailing Address - Phone:210-812-2170
Mailing Address - Fax:
Practice Address - Street 1:200 CONCORD PLAZA DR STE 780
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6972
Practice Address - Country:US
Practice Address - Phone:210-812-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.128894207P00000X
IN01059834A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine