Provider Demographics
NPI:1366421380
Name:SCHMIDT, FREDERICK KENNETH (PA C)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:KENNETH
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PA C
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Mailing Address - Street 1:PO BOX 6216A ATTN PROFESSIONAL AFFAIRS COORDINATOR
Mailing Address - Street 2:1 PINCKNEY BLVD NAVAL HOSPITAL BEAUFORT
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6148
Mailing Address - Country:US
Mailing Address - Phone:843-228-5577
Mailing Address - Fax:843-228-5196
Practice Address - Street 1:1 PINCKNEY BLVD NAVAL HOSPITAL BEAUFORT
Practice Address - Street 2:ATTN PROFESSIONAL AFFAIRS COORDINATOR
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6148
Practice Address - Country:US
Practice Address - Phone:843-228-5577
Practice Address - Fax:843-228-5196
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2025-02-21
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Provider Licenses
StateLicense IDTaxonomies
NCCPA 102628363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
000OTHMedicare UPIN