Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 60574 | MN |
Y | 111NI0900X | Internist | 60574 | MN |
NPI | 1003100595 |
---|---|
Provider Name | Carla Schultz |
First Address | Minneapolis, MN 55415-1829 |
Second Address | Minneapolis, MN 55415-1829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2011 |
Last Update Date | 07/08/2017 |