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NPI Code Detail

MEDICARE: DR. EDWARD RICHARD SCHULTZ M.D.

MEDICARE: DR. EDWARD RICHARD SCHULTZ 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
1207Q00000XFamily Medicine Physician348875-1205UT

General Provider Information

NPI Number : 1942287719
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD RICHARD SCHULTZ M.D.
Provider Business Mailing Address
First Line : 2225 PANORAMA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-2819
Country : US
Telephone Number : 801-274-0457
Fax Number :
Provider Business Practice Location Address
First Line : 1365 W 1000 N
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84116-1654
Country : US
Telephone Number : 801-328-5750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 12/31/2014

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