MEDICARE: DR. RONALD WALTER SCHUTZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		OR
2	207RC0000X	Cardiovascular Disease Physician	MD11311	OR

General Provider Information

NPI Number	:	1356346183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD WALTER SCHUTZ M.D.

Provider Business Mailing Address
First Line	:	19000 NW SQUIRRELTAIL LOOP
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-6784
Country	:	US
Telephone Number	:	503-805-0077
Fax Number	:

Provider Business Practice Location Address
First Line	:	19000 NW SQUIRRELTAIL LOOP
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-6784
Country	:	US
Telephone Number	:	503-805-0077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	01/05/2017

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