1447435763 NPI number — DR. THOMAS CHARLES SCHMIDT DC

Table of content: DR. THOMAS CHARLES SCHMIDT DC (NPI 1447435763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447435763 NPI number — DR. THOMAS CHARLES SCHMIDT DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT
Provider First Name:
THOMAS
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447435763
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8360 CITY CENTRE DR.
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
WOODBURY
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55125-3381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-735-2400
Provider Business Mailing Address Fax Number:
651-735-2410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8360 CITY CENTRE DR.
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
WOODBURY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55125-3381
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-735-2400
Provider Business Practice Location Address Fax Number:
651-735-2410
Provider Enumeration Date:
01/05/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2044 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)