Healthcare Provider Details

I. General information

NPI: 1336502640
Provider Name (Legal Business Name): ANDREW JOHN SCHULDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 JOHN R ST BOX 162
DETROIT MI
48201-2018
US

IV. Provider business mailing address

343 WRIGHT ST
WIXOM MI
48393-4317
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-7233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301110214
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: