Provider Demographics
NPI:1578636304
Name:SCHMIT, BERNDT P (MD)
Entity type:Individual
Prefix:
First Name:BERNDT
Middle Name:P
Last Name:SCHMIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4688
Mailing Address - Country:US
Mailing Address - Phone:510-683-9500
Mailing Address - Fax:
Practice Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4688
Practice Address - Country:US
Practice Address - Phone:510-683-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-06412085R0202X
LA3116712085R0202X
WA000360462085R0202X
DC51995042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM15002772Medicaid
WA8225039Medicaid
WA8802523Medicare ID - Type UnspecifiedTACOMA MAGNETIC IMAGING
WA8225039Medicaid
WAG68100Medicare UPIN
WA8801105Medicare ID - Type UnspecifiedUNION AVENUE OPEN MRI
NM15002772Medicaid