Provider Demographics
NPI:1790801066
Name:SCHOULTZ, NILS ANDERS (MD)
Entity Type:Individual
Prefix:DR
First Name:NILS
Middle Name:ANDERS
Last Name:SCHOULTZ
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 1:13208 BLUE WATER CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7128
Mailing Address - Country:US
Mailing Address - Phone:727-862-0412
Mailing Address - Fax:
Practice Address - Street 1:13208 BLUE WATER CT
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7128
Practice Address - Country:US
Practice Address - Phone:727-862-0412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL037165208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology