Provider Demographics
NPI:1588688493
Name:SCHMID, FREDERICK E (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:E
Last Name:SCHMID
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8059 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-1027
Mailing Address - Country:US
Mailing Address - Phone:734-426-4641
Mailing Address - Fax:734-426-0275
Practice Address - Street 1:8059 MAIN ST
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-1027
Practice Address - Country:US
Practice Address - Phone:734-426-4641
Practice Address - Fax:734-426-0275
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI20376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0156270001Medicare ID - Type Unspecified