Healthcare Provider Details

I. General information

NPI: 1518173657
Provider Name (Legal Business Name): SARAH E SCHULTZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 UNION AVE SUITE 200
MEMPHIS TN
38104-6638
US

IV. Provider business mailing address

2595 CENTRAL AVE
MEMPHIS TN
38104-5905
US

V. Phone/Fax

Practice location:
  • Phone: 901-260-8551
  • Fax: 901-260-8590
Mailing address:
  • Phone: 901-260-8551
  • Fax: 901-260-8590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301088315
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number47235
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: