Healthcare Provider Details

I. General information

NPI: 1477683324
Provider Name (Legal Business Name): DR. ROBERT JAMES SCHUTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 5TH ST SUITE 101
RAPID CITY SD
57701-6014
US

IV. Provider business mailing address

2820 MOUNT RUSHMORE RD
RAPID CITY SD
57701-5462
US

V. Phone/Fax

Practice location:
  • Phone: 605-343-7208
  • Fax: 605-343-7132
Mailing address:
  • Phone: 605-342-3280
  • Fax: 605-721-8458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number3685
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number3685
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: