Provider Demographics
NPI:1053519165
Name:JEFFREY C. SCHULTZ, M.D.
Entity type:Organization
Organization Name:JEFFREY C. SCHULTZ, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-529-6440
Mailing Address - Street 1:8817 BELAIR RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2425
Mailing Address - Country:US
Mailing Address - Phone:410-529-6440
Mailing Address - Fax:410-529-6793
Practice Address - Street 1:8817 BELAIR RD
Practice Address - Street 2:SUITE 111
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2425
Practice Address - Country:US
Practice Address - Phone:410-529-6440
Practice Address - Fax:410-529-6793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033728207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD837LMedicare UPIN