Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 36-00-3213 S | OH |
Y | 222Z00000X | Podiatrist | 36-00-3213 S | OH |
N | 213EP1101X | Primary Podiatric Medicine | 10405 | WV |
NPI | 1396857017 |
---|---|
Provider Name | Todd Schmidgall |
First Address | Cincinnati, OH 45223-1712 |
Second Address | South Charleston, WV 25309-1012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 13/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810016994 | (05) | WV |
7100128610 | (05) | KY |
P00831630 | RAILROAD MEDICARE WEST VIRGINIA (01) | WV |
U98034 | (02) | OH |