Individual
DEREK J SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-8550
(651) 254-8558
Mailing address
8170 33RD AVE, MAIL STOP 21110Q, BLOOMINGTON, MN 55425-4516
(952) 883-5340
(952) 853-8727
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
47090
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
996420700
—
MN
Enumeration date
03/25/2006
Last updated
07/09/2019
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