Individual
MARK J SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2855 CAMPUS DR, SUITE# 400, PLYMOUTH, MN 55441-2649
(763) 577-7400
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0222477
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110042052
RR MEDICARE
MN
05
—
514890100
—
MN
01
—
XX1920197003
BLUE CROSS BLUE SHIELD
MN
Enumeration date
08/30/2006
Last updated
09/17/2014
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