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NPI Code Detail

MEDICARE: DONALD H SHULLER M.D.

MEDICARE: DONALD H SHULLER 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
12085R0202XDiagnostic Radiology Physician9450OK

General Provider Information

NPI Number : 1912980137
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD H SHULLER M.D.
Provider Business Mailing Address
First Line : P.O. BOX 758
Second Line :
City : MCALESTER
State : OK
Zip : 74502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 E CLARK BASS BLVD
Second Line :
City : MCALESTER
State : OK
Zip : 74501-4209
Country : US
Telephone Number : 918-423-3602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 07/08/2007

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