Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 26151 | MN |
NPI | 1053339861 |
---|---|
Provider Name | Paul W Schultz |
First Address | St Cloud, MN 56303 |
Second Address | St Cloud, MN 56303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01271SC | BCBS (01) | |
075422 | (02) | |
102478 | UCARE (01) | |
1324452 | MEDICA (01) | |
532003 | P ONE (01) |