Healthcare Provider Details

I. General information

NPI: 1124100029
Provider Name (Legal Business Name): JOHN STEVEN SCHULTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4632 GENESYS PARKWAY MEDICAL REHABILITATION GROUP PC
GRAND BLANC MI
48439-8067
US

IV. Provider business mailing address

4632 GENESYS PARKWAY MEDICAL REHABILITATION GROUP PC
GRAND BLANC MI
48439-8067
US

V. Phone/Fax

Practice location:
  • Phone: 810-606-7181
  • Fax: 810-606-7174
Mailing address:
  • Phone: 810-606-7181
  • Fax: 810-606-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4301405898
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number4301405898
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: