Basic Information
| Provider Information | |||||||||
| NPI: | 1568808301 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMITT | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9203 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049159203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028959627 | ||||||||
| FaxNumber: | 5028958977 | ||||||||
| Practice Location | |||||||||
| Address1: | 3950 KRESGE WAY | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028958911 | ||||||||
| FaxNumber: | 5028958977 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2013 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 49377 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 50111326 | 01 | KY | PASSPORT | OTHER | 7100309970 | 05 | KY | MEDICAID |