Provider Demographics
NPI:1164591467
Name:SCHULTZ, KARA SUZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:SUZANNE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:SUZANNE
Other - Last Name:HEVENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:835 SWEITZER ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1077
Mailing Address - Country:US
Mailing Address - Phone:937-569-6937
Mailing Address - Fax:
Practice Address - Street 1:804 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331
Practice Address - Country:US
Practice Address - Phone:937-547-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.088909208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery