Individual
MARLIE DANA SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
71 HAYNES ST, EASTERN CONNECTICUT HEALTH NETWORK, MANCHESTER, CT 06040-4131
(860) 647-6475
Mailing address
71 HAYNES ST, EASTERN CONNECTICUT HEALTH NETWORK, MANCHESTER, CT 06040-4131
(860) 647-6475
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002418
CT
363AM0700X
Medical Physician Assistant
0049093
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003024189
—
CT
Enumeration date
10/19/2010
Last updated
06/07/2013
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