Provider Demographics
NPI:1073512224
Name:SCHMITT, SUSAN ANN (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ANN
Last Name:SCHMITT
Suffix:
Gender:
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:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:THOMAS
Mailing Address - State:WV
Mailing Address - Zip Code:26292-0025
Mailing Address - Country:US
Mailing Address - Phone:304-614-5899
Mailing Address - Fax:304-918-0185
Practice Address - Street 1:152 BLUEGRASS LN
Practice Address - Street 2:
Practice Address - City:HAMBLETON
Practice Address - State:WV
Practice Address - Zip Code:26269-8123
Practice Address - Country:US
Practice Address - Phone:304-614-5899
Practice Address - Fax:304-918-0185
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0050739000Medicaid
WV0050739000Medicaid