Basic Information
| Provider Information | |||||||||
| NPI: | 1023031119 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMITZ | ||||||||
| FirstName: | MIGUEL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 212 E CENTRAL AVE | ||||||||
| Address2: | SUITE 365 | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992086291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094350973 | ||||||||
| FaxNumber: | 5094350978 | ||||||||
| Practice Location | |||||||||
| Address1: | 212 E CENTRAL AVE | ||||||||
| Address2: | SUITE 365 | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992086291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094350973 | ||||||||
| FaxNumber: | 5094350978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 08/24/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD00038062 | WA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 8511032 | 05 | WA | MEDICAID |