Provider Demographics
NPI:1417903592
Name:SCHULTZ, CONSTANCE DAWN (PA)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:DAWN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-942-4000
Practice Address - Fax:412-942-2589
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002835L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA033200Medicare ID - Type Unspecified
PAS93493Medicare UPIN