Provider Demographics
NPI:1538117627
Name:SCHULTZ, PETER D (DPM)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:D
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 BOISE AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4214
Mailing Address - Country:US
Mailing Address - Phone:970-278-1440
Mailing Address - Fax:970-203-0329
Practice Address - Street 1:1440 BOISE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4214
Practice Address - Country:US
Practice Address - Phone:970-278-1440
Practice Address - Fax:970-203-0329
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO379213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01003797Medicaid
CO522488Medicare ID - Type Unspecified
CO01003797Medicaid