Healthcare Provider Details

I. General information

NPI: 1861735987
Provider Name (Legal Business Name): KATHERINE ANNE SCHULTES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N BROAD ST
WOODBURY NJ
08096-1617
US

IV. Provider business mailing address

1 COOPER PLZ
CAMDEN NJ
08103-1461
US

V. Phone/Fax

Practice location:
  • Phone: 856-853-2001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA09625200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: