Provider Demographics
NPI:1558332411
Name:SCHMIDT, BRADLEY A (MD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:M
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 70101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40270-0101
Mailing Address - Country:US
Mailing Address - Phone:812-945-3916
Mailing Address - Fax:812-944-3404
Practice Address - Street 1:1850 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4990
Practice Address - Country:US
Practice Address - Phone:812-944-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058990A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200357770OtherMANAGED HEALTH SERVICES
INP00141946OtherRAILROAD MEDICARE
IN000000336058OtherUNICARE
IN134960FOtherUNICARE MEDICARE
IN000000336058OtherANTHEM MEDICAID
IN200357770OtherMDWISE HOOSIER ALLIANCE
IN000000336058OtherINDIANA COMPREHENSIVE
IN000000336058OtherONE NATION BENEFIT
IN129703800OtherUS DEPT OF LABOR
IN000000336058OtherANTHEM
IN000000336058OtherHEALTHLINK
IN129703800OtherBLACK LUNG PROGRAM
IN2446645000OtherPASSPORT ADVANTAGE
IN000000336058OtherANTHEM SENIOR ADVANTAGE
KY000000336058OtherANTHEM
IN200357770Medicaid
IN134960FMedicare PIN
IN000000336058OtherANTHEM SENIOR ADVANTAGE
IN129703800OtherUS DEPT OF LABOR