Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 17436 | NE |
Y | 208000000X | Pediatrician | 17436 | NE |
NPI | 1720027428 |
---|---|
Provider Name | Mr. Michael Alan Schmidt |
First Address | Lincoln, NE 68510-4283 |
Second Address | Lincoln, NE 68510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 25/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00204 | BCBS - SURGICAL ASSOC (01) | NE |
100129760C | (05) | KS |
47075078113 | (05) | NE |
A02645 | (02) |