Healthcare Provider Details

I. General information

NPI: 1447472469
Provider Name (Legal Business Name): SCOTT M SCHULZE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 BLACK SWAN DRIVE SUITE 201
LEWES DE
19958-4988
US

IV. Provider business mailing address

211 EXECUTIVE DR STE 11
NEWARK DE
19702-3358
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-3311
  • Fax: 302-644-3300
Mailing address:
  • Phone: 302-451-6913
  • Fax: 302-368-7756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number036-116390
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0008726
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberC1-0008726
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: