Provider Demographics
NPI:1033188719
Name:SCHULTZ, STEPHEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8301 HARCOURT RD STE 205
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2082
Mailing Address - Country:US
Mailing Address - Phone:317-228-3393
Mailing Address - Fax:317-228-3397
Practice Address - Street 1:8301 HARCOURT RD STE 205
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2082
Practice Address - Country:US
Practice Address - Phone:317-228-3393
Practice Address - Fax:317-228-3397
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01034317A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100086960Medicaid
IN100086960Medicaid
INC25663Medicare UPIN
P00204341Medicare PIN