Provider Demographics
NPI:1063409316
Name:SCHMID, MATTHEW A (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:SCHMID
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7116 SIX FORKS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6157
Mailing Address - Country:US
Mailing Address - Phone:919-847-3122
Mailing Address - Fax:919-847-3148
Practice Address - Street 1:7116 SIX FORKS RD
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6157
Practice Address - Country:US
Practice Address - Phone:919-847-3122
Practice Address - Fax:919-847-3148
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908820Medicaid
NC561385693OtherTAX ID #
244425AMedicare PIN
NCT64461Medicare UPIN