Provider Demographics
NPI:1225101314
Name:SCHULTZ, DON (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:
Last Name:SCHULTZ
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:PO BOX 4846
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-4846
Mailing Address - Country:US
Mailing Address - Phone:406-502-1541
Mailing Address - Fax:406-502-1542
Practice Address - Street 1:2475 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4928
Practice Address - Country:US
Practice Address - Phone:406-447-2427
Practice Address - Fax:406-444-2126
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7631174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT105443Medicaid
MTF90655Medicare UPIN