Healthcare Provider Details

I. General information

NPI: 1881660918
Provider Name (Legal Business Name): JEFFREY SCHULTZE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 FOLLY RD SUITE A
CHARLESTON SC
29412-2625
US

IV. Provider business mailing address

PO BOX 13955
CHARLESTON SC
29422-3955
US

V. Phone/Fax

Practice location:
  • Phone: 843-795-5362
  • Fax: 843-795-1921
Mailing address:
  • Phone: 843-795-5362
  • Fax: 843-795-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18940
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: