Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MA59192 | MA |
NPI | 1043316409 |
---|---|
Provider Name | Kevin E Schmidt |
First Address | Springfield, MA 01104-3581 |
Second Address | Springfield, MA 01104-3581 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 16/08/2016 |