Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | LL31983 | SC |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD20160873 | NM |
NPI | 1386872497 |
---|---|
Provider Name | Gregg William Schmedes |
First Address | Spanish Fork, UT 84660-1008 |
Second Address | Albuquerque, NM 87106-2719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 14/07/2020 |