Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD200056 | OR |
NPI | 1295148757 |
---|---|
Provider Name | Paul Albert Shultz |
First Address | Bend, OR 97701-3887 |
Second Address | Bend, OR 97701-3887 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 12/03/2021 |