Provider Demographics
NPI:1760446140
Name:SCHULTZ, THOMAS ANDREW (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREW
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:40 E MAIN ST
Mailing Address - Street 2:STE 5
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-1331
Mailing Address - Country:US
Mailing Address - Phone:413-967-6681
Mailing Address - Fax:413-967-4561
Practice Address - Street 1:40 E MAIN ST
Practice Address - Street 2:STE 5
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1331
Practice Address - Country:US
Practice Address - Phone:413-967-6681
Practice Address - Fax:413-967-4561
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2847152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
854OtherDAVIS VISION
MA0340022Medicaid
MA042726810OtherHEALTH NET FEDERAL SERVICES
22-00352OtherUNITED HEALTHCARE
MA98036501OtherNETWORK HEALTH
W15462OtherBC/BS
624064OtherTRIGON BC/BS
MA725516OtherTUFTS HEALTH PLAN
110316OtherEYEMED VISION CARE
150908OtherHARVARD PILGRIM
MA16246OtherHEALTH NEW ENGLAND
MA187058OtherRAILROAD MEDICARE
MA6930OtherHEALTHNET
MA042726810OtherNEIGHBORHOOD HEALTH PLAN
MA042726810OtherTRICARE NORTH
18716OtherSPECTERA
742681OtherCONNECTICARE INS CO
22-00352OtherUNITED HEALTHCARE
742681OtherCONNECTICARE INS CO
MA0238250001Medicare NSC