Healthcare Provider Details

I. General information

NPI: 1902138993
Provider Name (Legal Business Name): HOWARD L. SCHULTHEISS, JR., DPM, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 S MAIN ST
BEL AIR MD
21014-3919
US

IV. Provider business mailing address

437 S MAIN ST
BEL AIR MD
21014-3919
US

V. Phone/Fax

Practice location:
  • Phone: 410-836-0131
  • Fax: 410-836-8594
Mailing address:
  • Phone: 410-836-0131
  • Fax: 410-836-8594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number01108
License Number StateMD

VIII. Authorized Official

Name: MRS. VICKIE LYNN SCHULTHEISS
Title or Position: MEDICAL ADMINISTRATOR
Credential: MT ASCP
Phone: 410-836-0131