Provider Demographics
NPI:1538199518
Name:ERIC S SCHMIDT, MD, INC
Entity type:Organization
Organization Name:ERIC S SCHMIDT, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:STEPHAN
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-544-3584
Mailing Address - Street 1:525 DOYLE PARK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4516
Mailing Address - Country:US
Mailing Address - Phone:707-544-3584
Mailing Address - Fax:707-544-3251
Practice Address - Street 1:525 DOYLE PARK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4516
Practice Address - Country:US
Practice Address - Phone:707-544-3584
Practice Address - Fax:707-544-3251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ01631ZMedicare ID - Type Unspecified