Healthcare Provider Details

I. General information

NPI: 1730697756
Provider Name (Legal Business Name): AMY SCHULTZ MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 LANSING AVE STE 221
JACKSON MI
49202-2193
US

IV. Provider business mailing address

1 S JACKSON SQ FL 5
JACKSON MI
49201-1457
US

V. Phone/Fax

Practice location:
  • Phone: 517-788-4420
  • Fax:
Mailing address:
  • Phone: 517-205-7433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number4301081188
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: