Healthcare Provider Details

I. General information

NPI: 1891834164
Provider Name (Legal Business Name): MARGARITA M AND ROBERT G SHULTZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MILLERSVILLE PIKE
LANCASTER PA
17603-6614
US

IV. Provider business mailing address

1300 MILLERSVILLE PIKE
LANCASTER PA
17603-6614
US

V. Phone/Fax

Practice location:
  • Phone: 717-393-5891
  • Fax: 717-393-3774
Mailing address:
  • Phone: 717-393-5891
  • Fax: 717-393-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD009048E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD011168E
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT GLENN SHULTZ
Title or Position: DOCTOR
Credential: M.D.
Phone: 717-393-5891