Provider Demographics
NPI:1740926542
Name:SCHMIDT, SAMUEL THOMAS (PA-C)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:THOMAS
Last Name:SCHMIDT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2287 CAMINO DE SUENOS
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-7802
Mailing Address - Country:US
Mailing Address - Phone:715-501-8188
Mailing Address - Fax:
Practice Address - Street 1:280 1ST ST BLDG 23
Practice Address - Street 2:
Practice Address - City:HOLLOMAN AFB
Practice Address - State:NM
Practice Address - Zip Code:88330-8273
Practice Address - Country:US
Practice Address - Phone:575-572-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2023-03-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant