Provider Demographics
NPI:1891793790
Name:SCHULTZ, STEVEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:SCHULTZ
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 1:4217 28TH AVE NW STE 111
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8296
Mailing Address - Country:US
Mailing Address - Phone:405-310-4211
Mailing Address - Fax:405-857-7215
Practice Address - Street 1:4217 28TH AVE NW STE 111
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8296
Practice Address - Country:US
Practice Address - Phone:405-310-4211
Practice Address - Fax:405-857-7215
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23705174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK7615521OtherAETNA
OK0195480001OtherPALMETTO
OK200065710AMedicaid