Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 013625 | KS |
NPI | 1013009919 |
---|---|
Provider Name | Myron C Schmidt |
First Address | Overland Park, KS 66223 |
Second Address | Overland Park, KS 66223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09297015 | BLUE CROSS BLUE SHIELD (01) | KS |