Provider Demographics
NPI:1063480069
Name:SCHULTZ, CARY THOMAS (CRNA)
Entity Type:Individual
Prefix:MR
First Name:CARY
Middle Name:THOMAS
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:100 BREWSTER BLVD
Mailing Address - Street 2:NAVAL HOSPITAL
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547
Mailing Address - Country:UM
Mailing Address - Phone:910-450-4136
Mailing Address - Fax:910-450-4558
Practice Address - Street 1:100 BREWSTER BLVD
Practice Address - Street 2:NAVAL HOSPITAL
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547
Practice Address - Country:UM
Practice Address - Phone:910-450-4136
Practice Address - Fax:910-450-4558
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2009-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA054263367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered