Provider Demographics
NPI:1801831177
Name:FERNANDEZ-SCHMIDT, DIANA (MD)
Entity type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:
Last Name:FERNANDEZ-SCHMIDT
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 890273
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0273
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2798
Practice Address - Country:US
Practice Address - Phone:828-732-7600
Practice Address - Fax:828-732-7601
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS85492084N0400X
NC2025-001452084N0400X
AZ515322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1706469Medicaid
LA4K180Medicare ID - Type UnspecifiedMEDICARE