Basic Information
| Provider Information | |||||||||
| NPI: | 1346655198 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMALZ | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2801 W KINNICKINNIC RIVER PKWY STE 1080 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532153689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4149086500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2801 W KINNICKINNIC RIVER PKWY STE 1080 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532153689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4149086500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2014 | ||||||||
| LastUpdateDate: | 01/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301106214 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 390200000X | 4301106214 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RG0100X | 72844-20 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.