Provider Demographics
NPI:1245205202
Name:SCHULTE, ERIK N (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:N
Last Name:SCHULTE
Suffix:
Gender:M
Credentials:DO
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 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:201 RIDGE ST STE 312
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4643
Practice Address - Country:US
Practice Address - Phone:712-396-7800
Practice Address - Fax:712-396-7885
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54969-021207V00000X
NE428207V00000X
IADO-04604207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026480117Medicaid
IAI03700016OtherMEDICARE
IA1245205202Medicaid
NE098962018OtherMEDICARE
NE10026211300Medicaid