Provider Demographics
NPI:1740564293
Name:SCHULTE, MARYANA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARYANA
Middle Name:
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 SOUTH KINGSHIGHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109
Mailing Address - Country:US
Mailing Address - Phone:314-773-1384
Mailing Address - Fax:
Practice Address - Street 1:3822 S KINGSHIGHWAY BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1817
Practice Address - Country:US
Practice Address - Phone:314-773-1384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003000300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist