Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 200100089 | NC |
NPI | 1194716936 |
---|---|
Provider Name | Karen Russell Schmidt |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2005 |
Last Update Date | 31/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1272V | BCBS NC (01) | NC |
370017971 | RAILROAD MEDICARE (01) | NC |
891272V | (05) | NC |
F37517 | (02) | NC |