Provider Demographics
NPI:1336234632
Name:SCHMID, TANIA LISETTE (MD)
Entity type:Individual
Prefix:DR
First Name:TANIA
Middle Name:LISETTE
Last Name:SCHMID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411421
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-1421
Mailing Address - Country:US
Mailing Address - Phone:314-619-3785
Mailing Address - Fax:
Practice Address - Street 1:232 S. WOODS MILL RD.
Practice Address - Street 2:PROFESSIONAL SERVICES
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3406
Practice Address - Country:US
Practice Address - Phone:314-619-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR9H57207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE14609Medicare UPIN