Provider Demographics
NPI:1578526802
Name:SCHULLER, DOUGLAS L (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:L
Last Name:SCHULLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:1000 LINCOLN CIR SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1862
Mailing Address - Country:US
Mailing Address - Phone:712-737-2000
Mailing Address - Fax:712-737-2115
Practice Address - Street 1:1000 LINCOLN CIR SE
Practice Address - Street 2:SUITE 100
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1862
Practice Address - Country:US
Practice Address - Phone:712-737-2000
Practice Address - Fax:712-737-2115
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA001591363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA50811OtherSIOUX VALLEY HEALTH PLAN
IA6099788Medicaid
IA237266OtherCOVENTRY HEALTH CARE
IA01-24268OtherMEDICA - HOSPERS SITE
IA01-23798OtherMEDICA - MILLCREEK SITE
IA09578OtherWELLMARK BS - ER SITE
IA248342OtherMIDLANDS CHOICE
IA01-24267OtherMEDICA - ORANGE CITY SITE
IA0634626Medicaid
IA42-6038405OtherSELECTFIRST
IA426038405OtherCIGNA
IA720911046919OtherPREFERRED ONE
IA720911046919OtherPREFERRED ONE
IA50811OtherSIOUX VALLEY HEALTH PLAN
IA248342OtherMIDLANDS CHOICE
IAI0524005Medicare PIN