Provider Demographics
NPI:1316905516
Name:SCHMIDT, MICHAEL P (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N SHIAWASSEE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1601
Mailing Address - Country:US
Mailing Address - Phone:989-541-2663
Mailing Address - Fax:989-723-3601
Practice Address - Street 1:819 N SHIAWASSEE ST STE 200
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1601
Practice Address - Country:US
Practice Address - Phone:989-541-2663
Practice Address - Fax:989-723-3601
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009047207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1316905516Medicaid
2057800365OtherBCBSM PIN
MI2659449Medicaid
0186300565OtherHEALTHPLUS
0M09140004Medicare PIN
MI2659449Medicaid