Provider Demographics
NPI:1083130231
Name:SHULER, ALFRED TITUS SR
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:TITUS
Last Name:SHULER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:SCHENTSKA
Other - Middle Name:YEVETTE
Other - Last Name:SHULER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:448 RACINE DR APT 209
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8786
Mailing Address - Country:US
Mailing Address - Phone:910-352-1695
Mailing Address - Fax:
Practice Address - Street 1:448 RACINE DR APT 209
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8786
Practice Address - Country:US
Practice Address - Phone:910-352-1695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8774044172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty