Provider Demographics
NPI:1730168642
Name:SCHMITZ, STEPHEN EARL (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:EARL
Last Name:SCHMITZ
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 1:70 MEDICAL CENTER CIR STE 208
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2273
Mailing Address - Country:US
Mailing Address - Phone:434-295-0184
Mailing Address - Fax:434-295-2463
Practice Address - Street 1:70 MEDICAL CENTER CIR STE 208
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-932-5926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027188208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA015815OtherANTHEM/BLUE CROSS
VA007562594Medicaid
VA007562594Medicaid
340005400Medicare PIN
VAB62115Medicare UPIN