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General NPI Number Information
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NPI Number | 1821291881
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Entity Type | Individual
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Provider Name | RANDALL E SCHULTZE PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 411 NAOMI ST
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City | PLAINWELL
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State | MI
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Zip | 49080-1222
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Country | US
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Telephone | 269-685-0796
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Fax |
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Provider Business Mailing Address
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Address Line | 4309 BRONSON BLVD
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City | KALAMAZOO
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State | MI
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Zip | 49008-3211
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Country | US
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Telephone | 269-383-8202
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601001789
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License Number State | MI
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