Provider Demographics
NPI:1699744789
Name:SCHMITZ, MICHAEL LEONARD (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEONARD
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1520 WHITNEY CT
Mailing Address - Street 2:CENTRACARE CLINIC - HEARTLAND FAMILY MEDICINE
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1899
Mailing Address - Country:US
Mailing Address - Phone:320-251-1775
Mailing Address - Fax:507-723-6447
Practice Address - Street 1:1520 WHITNEY CT
Practice Address - Street 2:CENTRACARE CLINIC - HEARTLAND FAMILY MEDICINE
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1899
Practice Address - Country:US
Practice Address - Phone:320-251-1775
Practice Address - Fax:507-723-6447
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN27093207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN583308600Medicaid
MN080006331Medicare ID - Type Unspecified
MN583308600Medicaid