Provider Demographics
NPI:1851326847
Name:SCHULZ, MONA LISA A (MD)
Entity Type:Individual
Prefix:
First Name:MONA LISA
Middle Name:A
Last Name:SCHULZ
Suffix:
Gender:F
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:PO BOX 1020
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-2020
Mailing Address - Country:US
Mailing Address - Phone:207-846-0010
Mailing Address - Fax:
Practice Address - Street 1:21 NORTHBROOK DR
Practice Address - Street 2:SUITE #21B
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1346
Practice Address - Country:US
Practice Address - Phone:207-846-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1542002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry