Provider Demographics
NPI:1083693337
Name:SCHULTE, JUSTIN M (OD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:M
Last Name:SCHULTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:309 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2946
Mailing Address - Country:US
Mailing Address - Phone:641-754-6262
Mailing Address - Fax:641-752-7420
Practice Address - Street 1:6200 WESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7705
Practice Address - Country:US
Practice Address - Phone:515-327-6100
Practice Address - Fax:515-223-5468
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA02267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
06170Medicare ID - Type Unspecified