Provider Demographics
NPI:1588892103
Name:SCHMIDT, AMBER RAE (DO)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:RAE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NH
Mailing Address - Zip Code:03584-3556
Mailing Address - Country:US
Mailing Address - Phone:604-788-2521
Mailing Address - Fax:603-788-5092
Practice Address - Street 1:170 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NH
Practice Address - Zip Code:03584-3556
Practice Address - Country:US
Practice Address - Phone:603-788-5029
Practice Address - Fax:603-788-5027
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077510Medicaid
VT1021101OtherMEDICARE PTAN - 003212401