Provider Demographics
NPI:1538707120
Name:SCHULTZ, SCHYLER M (PHARMD)
Entity Type:Individual
Prefix:
First Name:SCHYLER
Middle Name:M
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N65W24838 MAIN ST, SUSSEX, WI 53089
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089
Mailing Address - Country:US
Mailing Address - Phone:262-946-6363
Mailing Address - Fax:
Practice Address - Street 1:N65W24838 MAIN ST, SUSSEX, WI 53089
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089
Practice Address - Country:US
Practice Address - Phone:262-946-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-15
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19933-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist