Provider Demographics
NPI:1326048687
Name:SCHUTZ, LEONARD (MD, FACP)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:SCHUTZ
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 E MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-2243
Mailing Address - Country:US
Mailing Address - Phone:864-591-1700
Mailing Address - Fax:864-591-0007
Practice Address - Street 1:1455 E MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-2243
Practice Address - Country:US
Practice Address - Phone:864-591-1700
Practice Address - Fax:864-591-0007
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19003207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC190037Medicaid
4606363OtherCIGNA HEALTHCARE
SC190037Medicaid
SCA338375704Medicare PIN
SC830005337Medicare PIN