Provider Demographics
NPI:1336209691
Name:SCHULTZ, DAVID (OD, PC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:OD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE RD
Mailing Address - Street 2:STE 120A
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1426
Mailing Address - Country:US
Mailing Address - Phone:610-265-8831
Mailing Address - Fax:610-992-9943
Practice Address - Street 1:491 ALLENDALE RD
Practice Address - Street 2:STE 120A
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1426
Practice Address - Country:US
Practice Address - Phone:610-265-8831
Practice Address - Fax:610-992-9943
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-000720152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist