Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 6624 | AK |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301088267 | MI |
NPI | 1275758583 |
---|---|
Provider Name | Gabe Victor Schuldt |
First Address | Fairbanks, AK 99701-4922 |
Second Address | Fairbanks, AK 99701-4922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 12/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1009638 | (05) | AK |