Provider Demographics
NPI:1841280641
Name:SCHMITZER, ANDREW H (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:H
Last Name:SCHMITZER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11973 SWEETWATER DR
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-9196
Mailing Address - Country:US
Mailing Address - Phone:517-622-2020
Mailing Address - Fax:517-627-4397
Practice Address - Street 1:11973 SWEETWATER DR
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-9196
Practice Address - Country:US
Practice Address - Phone:517-622-2020
Practice Address - Fax:517-627-4397
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004026152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900B311150OtherBLUE CROSS BLUE SHIELD
MI7323885OtherAETNA
MI200000007557OtherPHP OF MID MICHIGAN
MI4986361Medicaid
MI2614422OtherUNITED HEALTHCARE
MI5997170001Medicare NSC
MIV06286Medicare UPIN
MI7323885OtherAETNA