Provider Demographics
NPI:1598874604
Name:SCHUTZ, RALPH A (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:A
Last Name:SCHUTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26340 W 108TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7423
Mailing Address - Country:US
Mailing Address - Phone:913-915-6032
Mailing Address - Fax:
Practice Address - Street 1:22334 W 66TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-3560
Practice Address - Country:US
Practice Address - Phone:913-825-0909
Practice Address - Fax:913-825-0905
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0421615207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST256711Medicare ID - Type Unspecified
C51364Medicare UPIN