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General NPI Number Information
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NPI Number | 1598720880
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Entity Type | Individual
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Provider Name | GRACE LAVERA SCHULTZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 745 S CHURCH ST STE 601
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City | MURFREESBORO
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State | TN
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Zip | 37130-4980
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Country | US
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Telephone | 423-495-7404
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Fax | 423-495-2625
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Provider Business Mailing Address
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Address Line | 745 S CHURCH ST STE 601
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City | MURFREESBORO
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State | TN
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Zip | 37130-4980
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Country | US
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Telephone | 615-767-9954
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Fax | 219-506-7653
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 31887
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000031887
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License Number State | TN
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