Provider Demographics
NPI:1114906617
Name:SCHULTE, DOUGLAS ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ROBERT
Last Name:SCHULTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-4080
Mailing Address - Country:US
Mailing Address - Phone:781-620-4888
Mailing Address - Fax:781-245-2602
Practice Address - Street 1:888 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-4080
Practice Address - Country:US
Practice Address - Phone:781-620-4888
Practice Address - Fax:781-245-2602
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA284255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine