Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2005012197 | MO |
N | 208600000X | Surgeon | 2005012197 | MO |
Y | 2086S0129X | Vascular Surgeon | 2005012197 | MO |
NPI | 1043254519 |
---|---|
Provider Name | Zachary C Schmittling |
First Address | Springfield, MO 65808-9007 |
Second Address | Springfield, MO 65807-5209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 03/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
199030 | BLUE CROSS/BLUE SHIELD (01) | |
207417700 | (05) | MO |
I30481 | (02) |