Healthcare Provider Details

I. General information

NPI: 1174589774
Provider Name (Legal Business Name): JEFFREY ALLEN SCHULTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 EAST CHICAGO STREET
COLDWATER MI
49036
US

IV. Provider business mailing address

PO BOX 1108
ANN ARBOR MI
48106-1108
US

V. Phone/Fax

Practice location:
  • Phone: 517-279-5400
  • Fax: 517-279-7140
Mailing address:
  • Phone: 517-279-5400
  • Fax: 517-279-7140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301082991
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: