Provider Demographics
NPI:1093910671
Name:SCHULTZ, SELMA J (DO)
Entity Type:Individual
Prefix:
First Name:SELMA
Middle Name:J
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-0766
Mailing Address - Country:US
Mailing Address - Phone:620-271-7400
Mailing Address - Fax:620-708-4027
Practice Address - Street 1:712A SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5128
Practice Address - Country:US
Practice Address - Phone:620-275-1766
Practice Address - Fax:620-275-4729
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010040490207V00000X, 207VG0400X
OH58002034207V00000X
NY390200000X
KS05-46884207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2010040490OtherSTATE LICENSE
OH58002034OtherMEDICAL LICENSE