Provider Demographics
NPI:1689673758
Name:SCHULTHEISS, HOWARD L JR (DPM, PA)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:L
Last Name:SCHULTHEISS
Suffix:JR
Gender:M
Credentials:DPM, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3919
Mailing Address - Country:US
Mailing Address - Phone:410-836-0131
Mailing Address - Fax:410-836-8594
Practice Address - Street 1:437 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3919
Practice Address - Country:US
Practice Address - Phone:410-836-0131
Practice Address - Fax:410-836-8594
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01108213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD158068000Medicaid
R7090001OtherBCBS NAT.
313968OtherMAMSI
0859210001OtherDMERC
1852436002OtherCIGNA
0468265OtherAETNA
357065900OtherOWCP
313968OtherMAMSI
R7090001OtherBCBS NAT.