Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS3113 | TN |
NPI | 1134128192 |
---|---|
Provider Name | Dr. Carl Walter Schulter |
First Address | Memphis, TN 38120-9475 |
Second Address | Memphis, TN 38120-9475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 08/07/2007 |