MEDICARE: DR. MICHAEL LEE SCHOLTZ DMD

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	1223G0001X	General Practice Dentistry	9053	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609839166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LEE SCHOLTZ DMD

Provider Business Mailing Address
First Line	:	928 NOTTINGHAM RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-6251
Country	:	US
Telephone Number	:	410-562-2820
Fax Number	:	252-737-7049

Provider Business Practice Location Address
First Line	:	1851 MACGREGOR DOWNS RD
Second Line	:	EAST CAROLINA UNIVERSITY SCHOOL OF DENTAL MEDICINE
City	:	GREENVILLE
State	:	NC
Zip	:	27834
Country	:	US
Telephone Number	:	252-737-7029
Fax Number	:	252-737-7041

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	08/01/2013

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