Provider Demographics
NPI:1033250055
Name:DR. HOWARD L. SCHULTHEISS, JR, DPM, P.A
Entity Type:Organization
Organization Name:DR. HOWARD L. SCHULTHEISS, JR, DPM, P.A
Other - Org Name:DR. HOWARD L. SCHULTHEISS, JR., DPM, P.A., ASC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHULTHEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MT ASCP
Authorized Official - Phone:410-836-0131
Mailing Address - Street 1:437 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3919
Mailing Address - Country:US
Mailing Address - Phone:410-836-0131
Mailing Address - Fax:410-836-8594
Practice Address - Street 1:437 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3919
Practice Address - Country:US
Practice Address - Phone:410-836-0131
Practice Address - Fax:410-836-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1308261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDNB7OtherBCBD DC
MD430341OtherCOVENTRY
MD6800184OtherUNITED HEALTH CARE
MDP00345657OtherRAILROAD MEDICARE
MD1852436003OtherCIGNA
MD3455399OtherAETNA
MD5814OtherELDER HEALTH
MD58355701OtherBCBS MD
MDR7090001OtherNATIONAL/CAPITAL BCBS
MD612357400OtherOWCP
MD1902138993OtherMEDICARE PECOS
MDNB7OtherBCBD DC