Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 4301405898 | MI |
N | 2081P2900X | Pain Medicine | 4301405898 | MI |
NPI | 1124100029 |
---|---|
Provider Name | John Steven Schultz |
First Address | Grand Blanc, MI 48439-8067 |
Second Address | Grand Blanc, MI 48439-8067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 29/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1997808 | (05) | MI |
B48473 | (02) | MI |