Healthcare Provider Details

I. General information

NPI: 1790612992
Provider Name (Legal Business Name): MICHAEL TIMOTHY SCHULTZE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

336 REVERE LN
TAYLOR PA
18517-1011
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-6597
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN722014
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: