Individual
JEFFREY CLARK SCHMIDLEIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
844 RITCHIE HWY, STE 206, SEVERNA PARK, MD 21146-4137
(410) 647-8300
(410) 315-8444
Mailing address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21146
(410) 647-8300
(410) 315-8444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D30741
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0553696119
UHC HMO
—
01
—
06246
AMERICAID
—
01
—
06731
PHN
—
01
—
110236249
MCRR
—
01
—
11129
BS POS
—
01
—
1S18
BS
—
01
—
2161151
US AETNA (HMO)
—
01
—
25990
PRIORITY
—
01
—
4324896
AETNA
—
01
—
486781500
MA
—
05
—
486781500
—
MD
01
—
522166976
TAX ID #
—
01
—
7495JC
MC
—
01
—
866083
MD/OP/ALLIANCE
—
01
—
T1980001
BSFED
—
Enumeration date
02/03/2006
Last updated
02/13/2017
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