Provider Demographics
NPI:1265025068
Name:SHULZE, JOHN EDWIN (BSEE MBA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWIN
Last Name:SHULZE
Suffix:
Gender:M
Credentials:BSEE MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3172 N RAINBOW BLVD UNIT 81053
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4534
Mailing Address - Country:US
Mailing Address - Phone:949-923-0832
Mailing Address - Fax:
Practice Address - Street 1:322 KAREN AVE UNIT 2005
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-0433
Practice Address - Country:US
Practice Address - Phone:949-923-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZB0301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherBiomedical Engineering