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NPI Code Detail

MEDICARE: BRUCE SCHULTZ M.D.

MEDICARE: BRUCE SCHULTZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036110300IL
2207Q00000XFamily Medicine PhysicianU0534TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356307433
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE SCHULTZ M.D.
Provider Business Mailing Address
First Line : PO BOX 742712
Second Line :
City : ATLANTA
State : GA
Zip : 30374-2712
Country : US
Telephone Number : 877-866-7123
Fax Number :
Provider Business Practice Location Address
First Line : 17218 PRESTON RD STE 2000
Second Line :
City : DALLAS
State : TX
Zip : 75252-4018
Country : US
Telephone Number : 954-399-4673
Fax Number : 309-543-2089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 06/14/2023

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