Provider Demographics
NPI:1437255254
Name:RICHARD C SCHULTZ MD & ASSOCIATES PC
Entity Type:Organization
Organization Name:RICHARD C SCHULTZ MD & ASSOCIATES PC
Other - Org Name:CASS STREET ENT & ASSOCIATES PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-714-9880
Mailing Address - Street 1:1104 CASS ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-3236
Mailing Address - Country:US
Mailing Address - Phone:231-941-1155
Mailing Address - Fax:231-941-1347
Practice Address - Street 1:1104 CASS ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3236
Practice Address - Country:US
Practice Address - Phone:231-941-1155
Practice Address - Fax:231-941-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054337174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty