Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1220 | WV |
N | 207Q00000X | Family Doctor | 102050222 | VA |
N | 207Q00000X | Family Doctor | 1220 | WV |
NPI | 1598798357 |
---|---|
Provider Name | Deborah Schmidt |
First Address | Lewisburg, WV 24901-1380 |
Second Address | Lewisburg, WV 24901-1380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 05/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11159993 | CAQH ID # (01) | |
1722723 | MTN STATE BCBS (01) | WV |
455534 | ANTHEM (01) | |
550779928 | FEIN (01) | |
5630404000 | (05) | WV |
F26537 | (02) |