Provider Demographics
NPI:1174671390
Name:SCHULTZ, JOHN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-861-7001
Mailing Address - Fax:303-861-8624
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:SUITE 6000
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-861-7001
Practice Address - Fax:303-861-8624
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO31983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO70770051Medicaid
CO01319839Medicaid
CO01319839Medicaid
COE98207Medicare UPIN
CO805163Medicare PIN
COP00821791Medicare PIN
CO805164Medicare PIN