MEDICARE: DOUGLAS E SCHULTZ MD

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	207R00000X	Internal Medicine Physician	39993	NC

General Provider Information

NPI Number	:	1487631859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS E SCHULTZ MD

Provider Business Mailing Address
First Line	:	218 FOUST ST STE C
Second Line	:
City	:	ASHEBORO
State	:	NC
Zip	:	27203-5476
Country	:	US
Telephone Number	:	336-625-2333
Fax Number	:	336-625-5511

Provider Business Practice Location Address
First Line	:	237 N FAYETTEVILLE ST STE D
Second Line	:
City	:	ASHEBORO
State	:	NC
Zip	:	27203-5573
Country	:	US
Telephone Number	:	336-625-2961
Fax Number	:	336-625-6573

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	12/08/2015

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